Individual provider Active NPI

Felicia Leisersohn, PSY.D.

  • Clinical Psychologist
  • Springfield, VA
National Provider Identifier
1316041429
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810002778 Issued in VA
Practice address
8348 Traford Lane
Suite 102
Springfield, VA 22152
Phone
(703) 569-8731
Fax
(703) 569-7248
NPI assigned
Sep 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0810002778 VA Primary

Addresses

Primary practice location

8348 Traford Lane
Suite 102
Springfield, VA 22152

Mailing address

8348 Traford Lane
Suite 102
Springfield, VA 22152
Phone (703) 569-8731

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20141212002300 VA Practitioner - Clinical Psychologist 0042351330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychological and Life Skills Associates PCGroup PAC ID 4688661838, 8 clinicians

Practice addresses (Care Compare)

13885 Hedgewood Dr
Woodbridge, VA 22193-7931
Phone (703) 490-0336

601 Emancipation Hwy
Suite 101
Fredericksburg, VA 22401-4564
Phone (703) 490-0336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0810002778VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological and Life Skills Associates, P.C. CurrentSince Sep 26, 2014 Accepting new patients

Locations

13885 Hedgewood Dr
Ste 245
Woodbridge, VA 22193
Phone (703) 490-0336

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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316041429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8348 TRAFORD LANE",
            "address_2": "SUITE 102",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "22152",
            "telephone_number": "703-569-8731",
            "fax_number": "703-569-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8348 TRAFORD LANE",
            "address_2": "SUITE 102",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "22152",
            "telephone_number": "703-569-8731",
            "fax_number": "703-569-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEISERSOHN",
        "first_name": "FELICIA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, VA

Sources for this page

Verify at the official NPI Registry.