Individual provider Active NPI

Nadezhda Vladagina, PSYD

  • Clinical Psychologist
  • Williamsburg, VA
National Provider Identifier
1093183741
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810007048 Issued in VA
Practice address
1651 Merrimac TRL
Williamsburg, VA 23185-5624
Phone
(757) 220-3200
NPI assigned
Sep 11, 2015
Last updated
Sep 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Psychologist 103TC0700X 0810007048 VA Primary
Forensic Psychologist 103TF0200X NU

Addresses

Primary practice location

1651 Merrimac TRL
Williamsburg, VA 23185-5624

Mailing address

1651 Merrimac TRL
Williamsburg, VA 23185-5624
Phone (646) 287-6551

Other practice location 1

1411 SW Morrison St
Suite 310
Portland, OR 97205-1945
Phone (503) 352-2400

Other practice location 2

4601 Ironbound Rd
Williamsburg, VA 23188-2648
Phone (757) 208-7955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0810007048VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Colonial Behavioral Health PastSince Sep 25, 2023 Accepting new patients

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": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1093183741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 MERRIMAC TRL",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855624",
            "telephone_number": "646-287-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 MERRIMAC TRL",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855624",
            "telephone_number": "757-220-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 SW Morrison St",
            "address_2": "Suite 310",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972051945",
            "country_code": "US",
            "telephone_number": "503-352-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4601 Ironbound Rd",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231882648",
            "country_code": "US",
            "telephone_number": "757-208-7955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VLADAGINA",
        "first_name": "NADEZHDA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-11",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007048",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.