Beth Gouse, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0810002067 Issued in VA

Practice address

1489 Chain Bridge Rd
203
MC Lean, VA 22101-5724

Phone

(703) 505-3163

NPI assigned

Feb 1, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1255879045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1489 CHAIN BRIDGE RD",
            "address_2": "203",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221015724",
            "telephone_number": "703-505-3163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1489 CHAIN BRIDGE RD",
            "address_2": "203",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221015724",
            "telephone_number": "703-505-3163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUSE",
        "first_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-01",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810002067",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "DC",
            "license": "PSY1775",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kyle Graham, DC
• Laura A Granato, PHD
• Eldesia Labren Granger, MD

• Psychologist in MC Lean, VA
• Providers in MC Lean, VA by specialty
• Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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.