Nisco Psychological Services PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

NISCO PSYCHOLOGICAL SERVICES PLLC

Doing business as

Patrick Nisco

Practice address

21351 Gentry Dr Ste 250
Sterling, VA 20166-8514

Phone

(037) 279-7297

Fax

(703) 421-9946

NPI assigned

Jan 3, 2023

Last updated

Jan 3, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tina Demeo

Title

Adminsitrator

Phone

(703) 581-8670

Specialties & licenses 1

Addresses

Other names 1

• Patrick Nisco Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patrick Joseph Nisco II, PH.D.

  • Clinical Psychologist
  • Ashburn, VA
  • NPI 1841395654
  NPD (past)

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672704000000",
    "number": "1174236343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21351 GENTRY DR STE 250",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201668514",
            "telephone_number": "703-727-9729",
            "fax_number": "703-421-9946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21351 GENTRY DR STE 250",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201668514",
            "telephone_number": "037-279-7297",
            "fax_number": "703-421-9946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NISCO PSYCHOLOGICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A",
        "authorized_official_last_name": "DEMEO",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "ADMINSITRATOR",
        "authorized_official_telephone_number": "703-581-8670"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patrick Nisco",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; 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.