Jeannine Marie Alfano-Gohman, PSY.D.
Individual provider Active NPI Clinical Psychologist · Manassas, VA
NPI 1184842932 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1184842932
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 0701004016 (VA)
- Practice address
- 8811 Sudley Rd Ste 211
Manassas, VA 20110-4750 - Phone
- (703) 725-1891
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701004016 | VA | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0701004016 | VA | Yes |
Addresses
Primary practice location
8811 Sudley Rd Ste 211
Manassas, VA 20110-4750
Mailing address
9002 Jackson Ave
Manassas, VA 20110-5052
Phone (703) 725-1891
Other providers in Manassas, VA
- Farh Alam Zada
- Rusul Albaldawi
- Keith Sumner Albertson
- Cristian Alcantara
- Katherine Alcantaracanales
- Hadeel Alfaysale
- Marilyn Renee Alger
- Mohammed Shoeb Ali
- Abdullah Alimam
- Lana Alimam
All providers in Manassas, VA · Clinical Psychologist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.