NPIMap

Organization Active NPI

Dulles Psychological Services LLC

  • Clinical Psychologist
  • Sterling, VA
National Provider Identifier
1225400310
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
081004794 Issued in VA
Legal business name
DULLES PSYCHOLOGICAL SERVICES LLC
Practice address
21351 Gentry Dr
Suite 250
Sterling, VA 20166-8510
Phone
(703) 828-7509
NPI assigned
Oct 28, 2015
Last updated
Oct 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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

Authorized official

Name
Dr. Caroline Ibrahim, PSY.D,NPI 1750533758
Title
Licensed Psychologist/Owner
Phone
(703) 828-7509

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 Psychologist 103TC0700X 081004794 VA Primary

Addresses

Primary practice location

21351 Gentry Dr
Suite 250
Sterling, VA 20166-8510

Mailing address

21351 Gentry Dr
Suite 250
Sterling, VA 20166-8510
Phone (703) 828-7509

National Provider Directory

National Provider Directory

Locations

21351 Gentry Dr
Ste 200
Sterling, VA 20166
Phone (703) 493-0891

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445990400000",
    "number": "1225400310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21351 GENTRY DR",
            "address_2": "SUITE 250",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201668510",
            "telephone_number": "703-828-7509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21351 GENTRY DR",
            "address_2": "SUITE 250",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201668510",
            "telephone_number": "703-828-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DULLES PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-28",
        "last_updated": "2015-10-28",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "703-828-7509",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D,"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "081004794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; 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.