Individual provider Active NPI

John L Hawley Jr., PH.D.

  • Clinical Psychologist
  • Sterling, VA
National Provider Identifier
1053452078
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810001126 Issued in VA
Practice address
6 Pidgeon Hill Dr
Suite 260
Sterling, VA 20165-6146
Phone
(703) 850-7300
Fax
(703) 430-9570
NPI assigned
Feb 11, 2007
Last updated
Nov 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X 0810001126 VA
Clinical Psychologist 103TC0700X 0810001126 VA Primary
Clinical Child & Adolescent Psychologist 103TC2200X 0810001126 VA

Addresses

Primary practice location

6 Pidgeon Hill Dr
Suite 260
Sterling, VA 20165-6146

Mailing address

202 Hawkins LN
Potomac Falls, VA 20165-5827
Phone (703) 850-7300

Other identifiers 3

IdentifierTypeStateIssuer
7713649MedicaidVA
214975OtherVAANTHEM BCBS
452614OtherVAMAMSI UNITEDHEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191029001965 VA Practitioner - Clinical Psychologist 3779815519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6 Pidgeon Hill Dr
Suite 260
Sterling, VA 20165-6147
Phone (703) 850-7300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Hawley Consulting, LLC Addiction (Substance Use Disorder) CurrentSince Aug 16, 2019 Accepting new patients

Locations

2 Pidgeon Hill Dr
Sterling, VA 20165
Phone (703) 850-7300

6 Pidgeon Hill Dr
Ste 260
Sterling, VA 20165
Phone (703) 404-2701

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1053452078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 HAWKINS LN",
            "city": "POTOMAC FALLS",
            "state": "VA",
            "postal_code": "201655827",
            "telephone_number": "703-850-7300",
            "fax_number": "703-430-9570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PIDGEON HILL DR",
            "address_2": "SUITE 260",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201656146",
            "telephone_number": "703-850-7300",
            "fax_number": "703-430-9570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWLEY",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-11",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0810001126",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001126",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "VA",
            "license": "0810001126",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7713649",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "214975",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI UNITEDHEALTHCARE",
            "identifier": "452614",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

Verify at the official NPI Registry.