Collaborative Support Psychological Services PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

COLLABORATIVE SUPPORT PSYCHOLOGICAL SERVICES PLLC

Practice address

1224 Bishopsgate Way
Reston, VA 20194-1414

Phone

(703) 915-3025

NPI assigned

Mar 27, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Aneta Kern, PHDNPI 1063880946

Title

Psychologist

Phone

(703) 915-3025

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Aneta Kern, PH.D.

  • Clinical Psychologist
  • Reston, VA
  • NPI 1063880946

  Clinical

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1033812045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 BISHOPSGATE WAY",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201941414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 BISHOPSGATE WAY",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201941414",
            "telephone_number": "703-915-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE SUPPORT PSYCHOLOGICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A",
        "authorized_official_last_name": "KERN",
        "authorized_official_first_name": "ANETA",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "703-915-3025",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Coggeshall
• Robin Susan Cohen, LCSW
• Tamara Cohen
• Wendy Nichole Cohen, P.A.
• Sarah W Coleman, C.N.P., M.S.N.
• Kristi Lauren Collman, OTR/L
• Colonfusion, LLC
• Columbia Behavioral Health PLLC
• Commonwealth Chiropractic Center of Reston, P.C.
• Compassus Op of Virginia LLC

• Clinical Psychologist in Reston, VA
• Providers in Reston, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.