Phyllis Brodie, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810002652 Issued in VA

Practice address

10580 Arrowhead Dr
Fairfax, VA 22030-7301

Phone

(571) 432-2780

NPI assigned

Mar 2, 2007

Sex

Female

Sole proprietor

Yes

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

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

Specialty

Clinical Psychologist

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth Counseling Associates IncGroup PAC ID 0941288583, 207 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Commonwealth Counseling Associates Inc

  dba LifeStance Health

  • Clinical Psychologist
  • Mechanicsville, VA
  • NPI 1851345805
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1194853846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10580 ARROWHEAD DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307301",
            "telephone_number": "571-432-2780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODIE",
        "first_name": "PHYLLIS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Brittain, M.A., CCC-SLP
• Molly Boyer Broache, W.H.N.P.
• Elizabeth Anne Brocato, LCSW
• Nancy Farmer Brockway, OT/L
• Richard Arthur Broderick, MD
• Clinton Lee Brogdon, LPC
• Erin Quigley Brognano, MS, OTR/L
• Nancy Maxine Bromberg, VMD
• Najah Bronson
• Mary Elizabeth Brooke, OTR/L

• 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 Jan 5, 2015; 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.