Keaton Somerville, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

810009390 Issued in VA

Practice address

3923 Blenheim Blvd Ste 62D
Fairfax, VA 22030-2428

Phone

(571) 520-5454

NPI assigned

Jul 28, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1396354072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3923 BLENHEIM BLVD STE 62D",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3923 BLENHEIM BLVD STE 62D",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302428",
            "telephone_number": "571-520-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMERVILLE",
        "first_name": "KEATON",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "810009390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "VH617031",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ekaterina Solovieva, DPT
• Farshad Soltanian
• Mark A Soltany, M.D.
• Ada Kathleen Somadelis, LCSW
• Steven Michael Somers, DDS
• Samantha Lynn Sommer, PHD
• Jessica Alexis Sommers
• Leia Hyunyoung Son
• Wonhye Son, D.C
• Eunhee Song, QMHP-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; 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.