Individual provider Active NPI

Cynthia Antoinette Jones, PH D

  • Clinical Psychologist
  • Leesburg, VA
National Provider Identifier
1457422958
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810001851 Issued in VA
Practice address
2 Cardinal Park Dr SE
Suite 104a
Leesburg, VA 20175-4448
Phone
(703) 779-8700
Fax
(703) 779-9767
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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 0810001851 VA Primary

Addresses

Primary practice location

2 Cardinal Park Dr SE
Suite 104a
Leesburg, VA 20175-4448

Mailing address

2 Cardinal Park Dr SE
Suite 104a
Leesburg, VA 20175-4448
Phone (703) 779-8700

Other identifiers 1

IdentifierTypeStateIssuer
207999OtherVAANTHEM BC BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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
I20150324000584 DC Practitioner - Clinical Psychologist 8820315211 Reassigns benefits to 1 organization
I20150717001872 VA Practitioner - Clinical Psychologist 8820315211 Reassigns benefits to 1 organization
Practice locations: Leesburg, VA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2 Cardinal Park Dr SE
Suite 104a
Leesburg, VA 20175-4448
Phone (703) 779-8700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0810001851VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychogeriatric Services LLC CurrentSince Jan 16, 2015 Accepting new patients
J L Fristad PLLC PastSince Aug 1, 2019 Accepting new patients

Locations

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

8575 Rixlew Ln
Manassas, VA 20109
Phone (703) 257-9770

Organizations & group practices 2

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1457422958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CARDINAL PARK DR SE",
            "address_2": "SUITE 104A",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201754448",
            "telephone_number": "703-779-8700",
            "fax_number": "703-779-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CARDINAL PARK DR SE",
            "address_2": "SUITE 104A",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201754448",
            "telephone_number": "703-779-8700",
            "fax_number": "703-779-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "CYNTHIA",
        "middle_name": "ANTOINETTE",
        "name_prefix": "Dr.",
        "credential": "PH D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "207999",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.