Organization Active NPI

Bespoke Psychiatry of Northern Virginia

  • Psychiatric/Mental Health Nurse Practitioner
  • Alexandria, VA
National Provider Identifier
1104768878
Registry record updated Apr 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
BESPOKE PSYCHIATRY OF NORTHERN VIRGINIA
Practice address
1737 King St Ste 330
Alexandria, VA 22314-2760
Phone
(301) 642-5404
NPI assigned
Apr 9, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2026

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

Authorized official

Name
Jennifer Linda Jordan, PMHNP-BCNPI 1861632176
Title
Owner
Phone
(301) 542-5404

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1737 King St Ste 330
Alexandria, VA 22314-2760

Mailing address

1737 King St Ste 330
Alexandria, VA 22314-2760
Phone (301) 642-5404

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1775692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777075200000",
    "number": "1104768878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1737 KING ST STE 330",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142760",
            "telephone_number": "301-642-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1737 KING ST STE 330",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142760",
            "telephone_number": "301-642-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BESPOKE PSYCHIATRY OF NORTHERN VIRGINIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-09",
        "last_updated": "2026-04-25",
        "certification_date": "2026-04-25",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LINDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-542-5404",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.