Nicole M Teske, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP7013 Issued in MN

Practice address

1875 Campus Commons Dr Ste 225
Reston, VA 20191-1533

Phone

(703) 879-2482

NPI assigned

Aug 6, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Guiding Star Psychological Services LLC

  • Clinical Psychologist
  • Plymouth, MN
  • NPI 1841182284
  Medicare reassignment NPD Authorized official
• Professional Psychological Services

  • Community/Behavioral Health Agency
  • Alexandria, VA
  • NPI 1255674206
  NPD (past)

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1184398778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11654 PLAZA AMERICA DR # 875",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201904700",
            "telephone_number": "703-879-2483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 CAMPUS COMMONS DR STE 225",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911533",
            "telephone_number": "703-879-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESKE",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810008344",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "07225",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP7013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Nicole Tea, PT, DPT
• Kathryn Hillary Tedeschi, ATR-BC, LPC
• Gerardo M Tejada
• Mark C Tekrony, PH.D., M.D.
• Tele-Physicians, P.C.
• Tessa Cholmondeley MD PC
• Tharapee Tha
• Thaddeus M Garland MD LLC
• John Thai, RPH
• June Thapa

• Clinical Psychologist in Reston, VA
• Providers in Reston, 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, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.