Raymond Abraham Bradni, PSYCHOLOGIST PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810007022 Issued in VA

Practice address

5244 Lyngate CT # 200
Burke, VA 22015-1631

Phone

(703) 537-5720

NPI assigned

Nov 19, 2020

Last updated

Dec 29, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 4, 2021 through Mar 4, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Dr. Goldberg & Associates

  • Clinical Psychologist
  • Vienna, VA
  • NPI 1437586526
  NPD (past)

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1609479781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2975 HUNTERS BRANCH RD UNIT 125",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220316066",
            "telephone_number": "559-917-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5244 LYNGATE CT # 200",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220151631",
            "telephone_number": "703-537-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADNI",
        "first_name": "RAYMOND",
        "middle_name": "ABRAHAM",
        "name_prefix": "Dr.",
        "credential": "PSYCHOLOGIST PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-19",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Lenore Bowling
• Emily Sandifer Boyd, D.M.D.
• Barbara Boyle, P.T.
• Daniel Ramon Bradford, RN
• Sally V Bradford, CNS
• Besime Dedey Brierton, PHARM.D.
• Brighthome Healthcare, LLC
• Richard Carl Brigleb, DDS
• Lauren Lee Britt, DPT
• Donna Louise Brooks, LPC

• Clinical Psychologist in Burke, VA
• Providers in Burke, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.