Nicole Pernod-Liboy, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810005594 Issued in VA

Practice address

1965 Jefferson Davis Hwy
Fredericksburg, VA 22401-6213

Phone

(540) 735-0560

NPI assigned

Dec 19, 2016

Last updated

Dec 19, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dougan and Walden Wellness PLLCGroup PAC ID 7012345267, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Dougan and Walden Wellness, PLLC

  • Psychologist
  • Midlothian, VA
  • NPI 1396259602
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1093259590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 JEFFERSON DAVIS HWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224016213",
            "telephone_number": "540-735-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 JEFFERSON DAVIS HWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224016213",
            "telephone_number": "540-735-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERNOD-LIBOY",
        "first_name": "NICOLE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-19",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ricky Alexander Perez-Macia
• Esther O. Perez-Quesada, BCABA, LABA
• Melissa Perez
• Performance Biomedical LLC
• Taryanna Perkins
• Ashtyn Perrin, OD
• Connie Perrin
• Tierra Shakita Perrin
• Arlene Roxanne Perry-Wright, DMD
• Steven Perry, RPH

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.