Individual provider Active NPI

Alec Lebedun, PH.D.

  • Clinical Neuropsychologist
  • Alexandria, VA
National Provider Identifier
1154441699
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
0810001828 Issued in VA
Practice address
600 Cameron St Ste 307
Alexandria, VA 22314-2506
Phone
(703) 283-3325
Fax
(571) 418-0078
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 0810001828 VA Primary

Addresses

Primary practice location

600 Cameron St Ste 307
Alexandria, VA 22314-2506

Mailing address

600 Cameron St Ste 307
Alexandria, VA 22314-2506
Phone (703) 283-3325

Other identifiers 1

IdentifierTypeStateIssuer
B570-0001OtherVACARE FIRST BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2026 through Jan 1, 2028

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6120 Brandon Ave
Suite 315
Springfield, VA 22150-2504

6120 Brandon Ave
Suite 315
Springfield, VA 22150-2584

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0810001828VAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Applied Neuropsychological Services, P.C. Clinical Neuropsychologist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1154441699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CAMERON ST STE 307",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142506",
            "telephone_number": "703-283-3325",
            "fax_number": "571-418-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CAMERON ST STE 307",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142506",
            "telephone_number": "703-283-3325",
            "fax_number": "571-418-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBEDUN",
        "first_name": "ALEC",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "VA",
            "license": "0810001828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST BLUE CROSS",
            "identifier": "B570-0001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.