Individual provider Active NPI

Kerstin Youman, PHD

  • Clinical Psychologist
  • Reston, VA
National Provider Identifier
1598454035
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810007887 Issued in VA
Practice address
11135 Watermans Dr
Reston, VA 20191-4311
Phone
(703) 462-4632
NPI assigned
May 2, 2023
Last updated
May 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2023

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 0810007887 VA Primary

Addresses

Primary practice location

11135 Watermans Dr
Reston, VA 20191-4311

Mailing address

11135 Watermans Dr
Reston, VA 20191-4311
Phone (703) 462-4632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Sep 14, 2023 through Sep 14, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0810007887VAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1598454035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11135 WATERMANS DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201914311",
            "telephone_number": "703-462-4632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11135 WATERMANS DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201914311",
            "telephone_number": "703-462-4632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUMAN",
        "first_name": "KERSTIN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.