Martina Pavlicek, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810004418 Issued in VA

Practice address

11130 Fairfax Blvd Ste 305
Fairfax, VA 22030-5035

Phone

(703) 691-1326

NPI assigned

Jun 3, 2011

Last updated

Jun 3, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1184918401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 YOAKUM PKWY UNIT 1802",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223043852",
            "telephone_number": "202-744-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11130 FAIRFAX BLVD STE 305",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305035",
            "telephone_number": "703-691-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLICEK",
        "first_name": "MARTINA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-03",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Paul, MSW, LSW
• Taylor Paul
• Jennifer Pauldurai, MD
• Kendra B Pauley
• Jason Pavelko, PA-C
• Rachael Pawlowicz, PSYD
• Darlene Payne Napper, AU.D.
• Abbigail Marie Payne
• Jordan Legendre Payne, LCSW
• Renee Payne, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; 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.