Individual provider Active NPI

Pourya Bahremand, PHD

  • Clinical Psychologist
  • Vienna, VA
National Provider Identifier
1053100115
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810008847 Issued in VA
Practice address
8000 Towers Crescent Dr FL 13
Vienna, VA 22182-6211
Phone
(301) 905-2295
NPI assigned
May 5, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810008847 VA Primary

Addresses

Primary practice location

8000 Towers Crescent Dr FL 13
Vienna, VA 22182-6211

Mailing address

8000 Towers Crescent Dr FL 13
Vienna, VA 22182-6211
Phone (301) 905-2295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0810008847VAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1053100115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 TOWERS CRESCENT DR FL 13",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221826211",
            "telephone_number": "301-905-2295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 TOWERS CRESCENT DR FL 13",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221826211",
            "telephone_number": "301-905-2295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHREMAND",
        "first_name": "POURYA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810008847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; 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.