Individual provider Active NPI

Nikolas Cirillo, PHD

  • Clinical Psychologist
  • Alexandria, VA
National Provider Identifier
1295608560
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810008990 Issued in VA
Practice address
1221 King St
Alexandria, VA 22314-2926
Phone
(571) 478-9499
NPI assigned
Sep 24, 2025
Last updated
Oct 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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 0810008990 VA Primary

Addresses

Primary practice location

1221 King St
Alexandria, VA 22314-2926

Mailing address

1221 King St
Alexandria, VA 22314-2926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 11, 2025 through Oct 11, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0810008990VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Old Town Psychology Clinical CurrentSince Oct 12, 2025 Accepting new patients

Locations

107 S West St
Alexandria, VA 22314
Phone (571) 305-0400

1221 King St
Alexandria, VA 22314
Phone (571) 478-9499

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1758672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1295608560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 KING ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 KING ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142926",
            "telephone_number": "571-478-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIRILLO",
        "first_name": "NIKOLAS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-24",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810008990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.