Active NPI
Bridget Dunnavant, PHD
- Clinical Psychologist
- Richmond, VA
National Provider Identifier
1114349974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810004912
- Practice address
- 1018 W 47TH St
Richmond, VA 23225-4649 - Phone
- (804) 223-0626
- NPI assigned
- Jan 14, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810004912 | VA | Primary |
Addresses
Primary practice location
1018 W 47TH St
Richmond, VA 23225-4649
Mailing address
1018 W 47TH St
Richmond, VA 23225-4649
Phone (804) 223-0626
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810004912 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455148800000",
"number": "1114349974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1018 W 47TH ST",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232254649",
"telephone_number": "804-223-0626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1018 W 47TH ST",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232254649",
"telephone_number": "804-223-0626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNNAVANT",
"first_name": "BRIDGET",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-14",
"last_updated": "2016-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810004912",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.