Active NPI
Elyssa Bonner
- School Psychologist
- Fairfax, VA
National Provider Identifier
1629610092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- PPS-0607528
- Practice address
- 8270 Willow Oaks Corporate Dr
Fairfax, VA 22031-4530 - Phone
- (571) 423-4900
- NPI assigned
- Oct 17, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | PPS-0607528 | VA | |
| School Psychologist | 103TS0200X | PPS-0607528 | VA | Primary |
Addresses
Primary practice location
8270 Willow Oaks Corporate Dr
Fairfax, VA 22031-4530
Mailing address
8270 Willow Oaks Corporate Dr
Fairfax, VA 22031-4530
Phone (571) 423-4900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PPS-0607528 | VA | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765843200000",
"number": "1629610092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8270 WILLOW OAKS CORPORATE DR",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220314530",
"telephone_number": "571-423-4900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8270 WILLOW OAKS CORPORATE DR",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220314530",
"telephone_number": "571-423-4900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONNER",
"first_name": "ELYSSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-17",
"last_updated": "2025-12-16",
"certification_date": "2025-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "VA",
"license": "PPS-0607528",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "VA",
"license": "PPS-0607528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.