NPIMap

Organization Active NPI

Clinical Psychology Services

  • Clinical Psychologist
  • Fairfax, VA
National Provider Identifier
1184034779
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
CLINICAL PSYCHOLOGY SERVICES
Practice address
11130 Fairfax Blvd
St. 305
Fairfax, VA 22030-5035
Phone
(703) 691-1326
NPI assigned
May 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Authorized official

Name
David William Ruxer, PH.D.
Title
Clinical Psychologist
Phone
(703) 691-1326

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

11130 Fairfax Blvd
St. 305
Fairfax, VA 22030-5035

Mailing address

11130 Fairfax Blvd
St. 305
Fairfax, VA 22030-5035

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399248000000",
    "number": "1184034779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11130 FAIRFAX BLVD",
            "address_2": "ST. 305",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11130 FAIRFAX BLVD",
            "address_2": "ST. 305",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305035",
            "telephone_number": "703-691-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL PSYCHOLOGY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-05-05",
        "status": "A",
        "authorized_official_last_name": "RUXER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "703-691-1326",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; 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.