Susan A Etkind, PSYD, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810004926 Issued in VA

Practice address

4339 Andes Dr
Fairfax, VA 22030-5360

Phone

(301) 312-1003

NPI assigned

Apr 5, 2010

Last updated

Jan 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Virginia Psychological Solutions PLLC

  • Clinical Psychologist
  • Fairfax, VA
  • NPI 1285371781

  DC

  Medicare reassignment NPD Authorized official
• Clinical Psychology Services PC

  • Clinical Psychologist
  • Fairfax, VA
  • NPI 1194818054

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1548585334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10332 MAIN ST # 282",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302410",
            "telephone_number": "703-673-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4339 ANDES DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305360",
            "telephone_number": "301-312-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETKIND",
        "first_name": "SUSAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSYD, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-05",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Phillip Essepian III, M.D.
• Essnv Surgical Suites LLC
• Mary Ellen Zator Estes, NP
• Nixsaliz Estevez Campos, M.S. SLP
• Emily Elizabeth Estrada, MA CCC-SLP
• Marc DH Eun, DMD
• Eutopia Medical Dermatology and Aesthetics PLLC
• Aimee Evans
• Ashleigh Evans
• Karen Evans

• 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 Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.