Old Town Professional Psychology

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

OLD TOWN PROFESSIONAL PSYCHOLOGY

Practice address

411 1/2 N Washington St
Alexandria, VA 22314-2311

Phone

(571) 327-0194

NPI assigned

May 5, 2020

Organization subpart

No

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

Authorized official

Name

Sundar Cook, PSY.DNPI 1881898609

Title

Psychologist

Phone

(540) 931-5238

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Practitioners 1

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

• Sundar John Cook, PSY.D.

  • Clinical Psychologist
  • Alexandria, VA
  • NPI 1881898609

  DC

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589328000000",
    "number": "1366063992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 1/2 N WASHINGTON ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142311",
            "telephone_number": "540-931-5238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 1/2 N WASHINGTON ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142311",
            "telephone_number": "571-327-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TOWN PROFESSIONAL PSYCHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-05",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "SUNDAR",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "540-931-5238",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychoanalyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Psychoanalysis",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://sundar-cook.clientsecure.me",
            "affiliation": "N",
            "address_1": "411 1/2 N Washington St",
            "city": "Alexandria",
            "state": "VA",
            "country_code": "US",
            "postal_code": "223142311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rebecca I Olatunji, RN
• Old Dominion Pharmacy LLC
• Old Town Alexandria Chiropractic LLC
• Old Town Dental Partners
• Old Town Dental Partners, PC
• Old Town Psychology
• Old Town Psychotherapy
• Old Town Therapy & Wellness Center, LLC
• Old Towne Chiropractic Services LTD
• Olde Towne Obstetrics & Gynecology, LLC

• Clinical Psychologist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.