Debra M Nackman, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810001415 Issued in VA

Practice address

405 N Washington St
Suite 104
Falls Church, VA 22046-3410

Phone

(703) 645-8700

Fax

(703) 533-9433

NPI assigned

Jan 29, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114063195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3331 MANTUA DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312712",
            "telephone_number": "703-645-8700",
            "fax_number": "703-533-9433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N WASHINGTON ST",
            "address_2": "SUITE 104",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220463410",
            "telephone_number": "703-645-8700",
            "fax_number": "703-533-9433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACKMAN",
        "first_name": "DEBRA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Falls Church, VA
• Providers in Falls Church, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.