Integrated Psychology Associates of McLean, LLC

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

VA0810003478 Issued in VA

Legal business name

INTEGRATED PSYCHOLOGY ASSOCIATES OF MCLEAN, LLC

Practice address

6845 Elm St Ste 507
MC Lean, VA 22101-3859

Phone

(703) 459-0417

Fax

(703) 454-0601

NPI assigned

Nov 28, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Debra N Brosius, PSY.DNPI 1588989404

Title

Director of Psychological Services

Phone

(703) 459-0417

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Debra N Brosius, PSY.D.

  • Clinical Psychologist
  • Tampa, FL
  • NPI 1588989404
  NPD Authorized official

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511827200000",
    "number": "1639683758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6845 ELM ST STE 507",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013859",
            "telephone_number": "703-459-0417",
            "fax_number": "703-454-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6845 ELM ST STE 507",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013859",
            "telephone_number": "703-459-0417",
            "fax_number": "703-454-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED PSYCHOLOGY ASSOCIATES OF MCLEAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-28",
        "last_updated": "2017-11-28",
        "status": "A",
        "authorized_official_last_name": "BROSIUS",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "DIRECTOR OF PSYCHOLOGICAL SERVICES",
        "authorized_official_telephone_number": "703-459-0417",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "VA",
            "license": "VA0810003478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "BN70001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cognitive & Behavioral Psychologist in MC Lean, VA
• Providers in MC Lean, VA by specialty
• Cognitive & Behavioral Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.