Tara Devi Smith, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810005135 Issued in VA

Practice address

13855 Hedgewood Drive
#245
Woodbridge, VA 22193

Phone

(703) 490-0336

NPI assigned

Feb 17, 2015

Sex

Female

Sole proprietor

No

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 VA

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

Group practices

Psychological and Life Skills Associates PCGroup PAC ID 4688661838, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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 and National Provider Directory roles.

• Psychological and Life Skills Associates, P.C.

  • Psychologist
  • Woodbridge, VA
  • NPI 1619066727
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424131200000",
    "number": "1639560378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13855 HEDGEWOOD DRIVE",
            "address_2": "#245",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22193",
            "telephone_number": "703-490-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13855 HEDGEWOOD DRIVE",
            "address_2": "#245",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22193",
            "telephone_number": "703-490-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TARA",
        "middle_name": "DEVI",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-17",
        "last_updated": "2015-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "DC",
            "license": "PSY1000948",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Bonita Smith
• Maudisa Smith
• Michael Q Smith, MD
• Paula Anne Smith, PT
• Rishawn Smith
• Thomas Smith
• Thomas Larry Smith, MD
• Kendra Nykole Smither, RIC
• SMP Companionship and Care, LLC
• Katherine Snably, PSY.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; 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.