Individual provider Active NPI

Denise Coltson, PHD

  • Psychologist
  • Fairfax, VA
National Provider Identifier
1073188306
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0810008091 Issued in VA
Practice address
8221 Willow Oaks Corporate Dr Ste 4-425
Fairfax, VA 22031-4512
Phone
(703) 289-7599
Fax
(703) 289-4612
NPI assigned
May 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0810008091 VA Primary

Addresses

Primary practice location

8221 Willow Oaks Corporate Dr Ste 4-425
Fairfax, VA 22031-4512

Mailing address

8221 Willow Oaks Corporate Dr Ste 4-425
Fairfax, VA 22031-4512
Phone (703) 289-7599

Other practice location 1

300 Crittenden Blvd
Rochester, NY 14642-0001
Phone (585) 275-3563

Other practice location 2

1215 Lee St
Charlottesville, VA 22908-0001
Phone (434) 924-5314

Other names 1

  • Denise Fedlan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20240305001585 DC Practitioner - Clinical Psychologist 5092150623 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0810008091VAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jan 14, 2024 Accepting new patients
Inova Health Care Services CurrentSince Jan 14, 2024 Accepting new patients

Locations

8505 Arlington Blvd
Ste 200
Fairfax, VA 22031
Phone (703) 698-8525

8221 Willow Oaks Corporate Dr
Ste 4425
Fairfax, VA 22031
Phone (703) 289-7599

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1073188306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8221 WILLOW OAKS CORPORATE DR STE 4-425",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314512",
            "telephone_number": "703-289-7599",
            "fax_number": "703-289-4612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8221 WILLOW OAKS CORPORATE DR STE 4-425",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314512",
            "telephone_number": "703-289-7599",
            "fax_number": "703-289-4612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Crittenden Blvd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146420001",
            "country_code": "US",
            "telephone_number": "585-275-3563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080001",
            "country_code": "US",
            "telephone_number": "434-924-5314",
            "fax_number": "434-243-4743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLTSON",
        "first_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810008091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "FEDLAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.