NPIMap

Organization Active NPI

Old Town Psychology

  • Clinical Psychologist
  • Alexandria, VA
National Provider Identifier
1194429191
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
OLD TOWN PSYCHOLOGY
Practice address
1221 King St
Alexandria, VA 22314-2926
Phone
(571) 478-9499
NPI assigned
Mar 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Authorized official

Name
Dr. Kathryn Ziemer, PHDNPI 1679040851
Title
Clinical Director
Phone
(571) 478-9499

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1221 King St
Alexandria, VA 22314-2926

Mailing address

107 S West St # 519
Alexandria, VA 22314-2824

National Provider Directory

National Provider Directory

Locations

1221 King St
Alexandria, VA 22314
Phone (571) 478-9499

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1194429191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S WEST ST # 519",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 KING ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142926",
            "telephone_number": "571-478-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TOWN PSYCHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A",
        "authorized_official_last_name": "ZIEMER",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "571-478-9499",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "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 Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.