Individual provider Active NPI

Erika Pruett, PSY.D.

  • Psychologist
  • Fairfax, VA
National Provider Identifier
1376172353
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0810008170 Issued in VA
Practice address
11204 Waples Mill Rd
Fairfax, VA 22030-6036
Phone
(703) 218-8500
Fax
(703) 359-0463
NPI assigned
Apr 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0810008170 VA Primary

Addresses

Primary practice location

11204 Waples Mill Rd
Fairfax, VA 22030-6036

Mailing address

11204 Waples Mill Rd
Fairfax, VA 22030-6036
Phone (703) 218-8500

Other practice location 1

8221 Willow Oaks Corporate Dr Ste 4-425
Fairfax, VA 22031-4512
Phone (703) 289-7599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221206001275 MA Practitioner - Clinical Psychologist 9032588587 Reassigns benefits to 1 organization
I20231031000846 DC Practitioner - Clinical Psychologist 9032588587 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0810008170VAMDPsychologist
11925MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Sep 17, 2023 Accepting new patients
Cambridge Public Health Commission CurrentSince Oct 24, 2022 Accepting new patients
Inova Health Care Services CurrentSince Sep 17, 2023 Accepting new patients
Cambridge Public Health Commission CurrentSince Oct 24, 2022 Accepting new patients

Locations

1493 Cambridge St
Bldg Med
Cambridge, MA 02139

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

350 Main St
Ste 31
Malden, MA 02148
Phone (781) 397-6583

454 Broadway
Revere, MA 02151
Phone (617) 389-4666

11204 Waples Mill Rd
Fairfax, VA 22030
Phone (703) 218-8500

8505 Arlington Blvd
Ste 200
Fairfax, VA 22031
Phone (703) 698-8525

8221 Willow Oaks Corporate Dr
Ste 4425
Fairfax, VA 22031
Phone (703) 289-7599

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1376172353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11204 WAPLES MILL RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306036",
            "telephone_number": "703-218-8500",
            "fax_number": "703-359-0463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11204 WAPLES MILL RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306036",
            "telephone_number": "703-218-8500",
            "fax_number": "703-359-0463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8221 Willow Oaks Corporate Dr Ste 4-425",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220314512",
            "country_code": "US",
            "telephone_number": "703-289-7599",
            "fax_number": "703-289-4612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUETT",
        "first_name": "ERIKA",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810008170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.