Individual provider Active NPI

Natalia Lugina Mauranne, MS, MA, PSYD

  • Clinical Neuropsychologist
  • Herndon, VA
National Provider Identifier
1528527140
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
0810005747 Issued in VA
Practice address
441D Carlisle Dr., Suite 103
Herndon, VA 20170-4802
Phone
(703) 715-7130
Fax
(833) 520-4863
NPI assigned
Mar 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 0810005747 VA Primary

Addresses

Primary practice location

441D Carlisle Dr., Suite 103
Herndon, VA 20170-4802

Mailing address

11446 Hollow Timber CT
Reston, VA 20194-1980
Phone (571) 529-2663

Other practice location 1

107 Carpenter Dr Ste 110
Sterling, VA 20164-4468
Phone (703) 297-4368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200604001488 DC Practitioner - Clinical Psychologist 4183957186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

441 -D Carlisle Dr
Suite 103
Herndon, VA 20170-4802
Phone (703) 715-7130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Master of Science

State licenses

LicenseStateTypeSpecialty
0810005747VAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Reston Precision Neuropsychology LLC Clinical Neuropsychologist CurrentSince Jan 6, 2020 Accepting new patients

Locations

441 Carlisle Dr
Ste 103
Herndon, VA 20170
Phone (703) 715-7130

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": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1528527140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11446 HOLLOW TIMBER CT",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201941980",
            "telephone_number": "571-529-2663",
            "fax_number": "833-520-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441D CARLISLE DR., SUITE 103",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704802",
            "telephone_number": "703-715-7130",
            "fax_number": "833-520-4863"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 Carpenter Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "VA",
            "postal_code": "201644468",
            "country_code": "US",
            "telephone_number": "703-297-4368",
            "fax_number": "571-512-7955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUGINA MAURANNE",
        "first_name": "NATALIA",
        "credential": "MS, MA, PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-13",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "VA",
            "license": "0810005747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

Verify at the official NPI Registry.