Elizabeth Ann Berendt, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810004235 Issued in VA

Practice address

10560 Main St
Suite 507
Fairfax, VA 22030-7182

Phone

(703) 691-1326

Fax

(703) 691-3553

NPI assigned

Mar 14, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Elizabeth Ann Berendt Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290384000000",
    "number": "1467586578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10560 MAIN ST",
            "address_2": "SUITE 507",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307182",
            "telephone_number": "703-691-1326",
            "fax_number": "703-691-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10560 MAIN ST",
            "address_2": "SUITE 507",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307182",
            "telephone_number": "703-691-1326",
            "fax_number": "703-691-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERENDT",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2010-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 14503",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "847",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "BERENDT",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Casey Raymond Benton, M.D.
• Theresa Benton
• Amin Benyounes, M.D.
• Tyler Berch, CRNA
• Grace Berczel, PHARMD
• Alyssa Berg, MA, CCC-SLP
• Tracy Marvin Berg III, LMT
• Robert M Berger, MD
• Shelby Berger, LCSW
• Sharlene Bergeron, BCBA

• 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 Nov 22, 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.