Nastassja Marshall, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810005475 Issued in VA

Practice address

3111 Northside Ave Ste 101
Richmond, VA 23228-5441

Phone

(917) 753-7593

NPI assigned

May 28, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 1, 2024 through Jun 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1093194664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 PARKWOOD AVE APT 106",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232213519",
            "telephone_number": "917-753-7593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 NORTHSIDE AVE STE 101",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232285441",
            "telephone_number": "917-753-7593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "NASTASSJA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-28",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gwendolyn Marshall, CNA
• Kathy L Marshall, MD
• Lindsay Anne Marshall, RBT
• Lindsay Noelle Marshall, PA
• Lori Anne Marshall, ACACNP-BC
• Phillip Marshall, MD
• Emily Fowler Marshman
• David W Marsland, M.D.
• Luisa Portal Marsteller, MD
• Michael F Martelli, PH.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.