Nouveau Psychological Wellness, PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

NOUVEAU PSYCHOLOGICAL WELLNESS, PLLC

Practice address

1530 Wilson Blvd Ste 360
Arlington, VA 22209-2466

Phone

(571) 534-3825

Fax

(571) 376-6941

NPI assigned

Nov 30, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Paige Victorine, PSY.D.NPI 1023788023

Title

Co-Owner

Phone

(571) 534-3825

Specialties & licenses 4

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paige Malia Victorine, PSYD

  • Clinical Psychologist
  • Arlington, VA
  • NPI 1023788023
  NPD Authorized official
• Jack David Baker, PHD

  • Psychologist
  • Arlington, VA
  • NPI 1073155453
  NPD

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1326814484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 WILSON BLVD STE 360",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222092466",
            "telephone_number": "571-534-3825",
            "fax_number": "571-376-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 WILSON BLVD STE 360",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222092466",
            "telephone_number": "571-534-3825",
            "fax_number": "571-376-6941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Wilson Blvd Ste 745",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222015424",
            "country_code": "US",
            "telephone_number": "571-534-3825",
            "fax_number": "571-376-6941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOUVEAU PSYCHOLOGICAL WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "VICTORINE",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "571-534-3825",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Arlington, VA
• Providers in Arlington, VA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.