Individual provider Active NPI

Alexandra Marie Coletta, PSY.D.

  • Clinical Psychologist
  • Midlothian, VA
National Provider Identifier
1194597153
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810008261 Issued in VA
Practice address
312 Browns Hill CT
Midlothian, VA 23114-9511
Phone
(804) 893-5555
NPI assigned
Oct 24, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810008261 VA Primary

Addresses

Primary practice location

312 Browns Hill CT
Midlothian, VA 23114-9511

Mailing address

9321 Brundidge Rd
North Chesterfield, VA 23236-3404
Phone (609) 827-2927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20250310003412 VA Practitioner - Clinical Psychologist 7416478151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dougan and Walden Wellness PLLCGroup PAC ID 7012345267, 9 clinicians

Practice addresses (Care Compare)

312 Browns Hill CT
Midlothian, VA 23114-9511
Phone (804) 893-5555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0810008261VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dougan and Walden Wellness, PLLC CurrentSince Nov 22, 2024 Accepting new patients

Locations

9568 Kings Charter Dr
Ashland, VA 23005

312 Browns Hill Ct
Midlothian, VA 23114
Phone (804) 651-1830

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1194597153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9321 BRUNDIDGE RD",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232363404",
            "telephone_number": "609-827-2927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 BROWNS HILL CT",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231149511",
            "telephone_number": "804-893-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLETTA",
        "first_name": "ALEXANDRA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810008261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.