Individual provider Active NPI

Kampbell Salehi, PSY.D.

  • Clinical Psychologist
  • Springfield, VA
National Provider Identifier
1407950512
Registry record updated Jan 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1037C0700X Issued in VA
Practice address
8134 Old Keene Mill Rd
Suite 101
Springfield, VA 22152-1800
Phone
(703) 569-8731
Fax
(703) 569-7248
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

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 1037C0700X VA Primary

Addresses

Primary practice location

8134 Old Keene Mill Rd
Suite 101
Springfield, VA 22152-1800

Mailing address

8134 Old Keene Mill Rd
Suite 101
Springfield, VA 22152-1800
Phone (703) 569-8731

Other identifiers 1

IdentifierTypeStateIssuer
010092736MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1037C0700XVAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Clinical Services Clinical PastSince May 1, 2008 Accepting new patients

Organizations & group practices 1

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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1407950512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8134 OLD KEENE MILL RD",
            "address_2": "SUITE 101",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221521800",
            "telephone_number": "703-569-8731",
            "fax_number": "703-569-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8134 OLD KEENE MILL RD",
            "address_2": "SUITE 101",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221521800",
            "telephone_number": "703-569-8731",
            "fax_number": "703-569-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALEHI",
        "first_name": "KAMPBELL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "1037C0700X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010092736",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; 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.