Individual provider Active NPI

Sally Kugler, PH.D.

  • Clinical Psychologist
  • Vienna, VA
National Provider Identifier
1366658007
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810000853 Issued in VA
Practice address
8308 Old Courthouse Rd Ste B
Vienna, VA 22182-3863
Phone
(703) 734-3515
NPI assigned
May 16, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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 0810000853 VA Primary

Addresses

Primary practice location

8308 Old Courthouse Rd Ste B
Vienna, VA 22182-3863

Mailing address

8308 Old Courthouse Rd Ste B
Vienna, VA 22182-3863
Phone (703) 734-3515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20120321000705 DC Practitioner - Clinical Psychologist 3678747698 Practice locations: Vienna, VA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8308 -B Old Courthouse Rd
Vienna, VA 22182-3863

8308 Old Courthouse Rd
Suite B
Vienna, VA 22182-3863
Phone (703) 734-3515

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0810000853VAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366658007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8308 OLD COURTHOUSE RD STE B",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823863",
            "telephone_number": "703-734-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8308 OLD COURTHOUSE RD STE B",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823863",
            "telephone_number": "703-734-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUGLER",
        "first_name": "SALLY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810000853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

Verify at the official NPI Registry.