Carol Clay, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810007698 Issued in VA

Practice address

26317 Washington St
North Dinwiddie, VA 23803-2727

Phone

(804) 524-4445

NPI assigned

Aug 29, 2018

Last updated

Sep 12, 2022By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1205318078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26317 W. WASHINGTON STREET",
            "address_2": "PO BOX 4030",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238032727",
            "telephone_number": "804-524-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26317 WASHINGTON ST",
            "city": "NORTH DINWIDDIE",
            "state": "VA",
            "postal_code": "238032727",
            "telephone_number": "804-524-4445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3810 W Broad St",
            "address_2": "Unit 1353",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232303969",
            "country_code": "US",
            "telephone_number": "314-517-0835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLAY",
        "first_name": "CAROL",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.