Active NPI
Johannaly Castro-Moreno, PSYCH
- Counseling Psychologist
- Lorton, VA
National Provider Identifier
1639831951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 4597
- Practice address
- 7603 Wildwood CT Apt C1
Lorton, VA 22079-1873 - Phone
- (571) 639-9754
- NPI assigned
- Oct 13, 2021
- Last updated
- Oct 13, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 4597 | PR | Primary |
Addresses
Primary practice location
7603 Wildwood CT Apt C1
Lorton, VA 22079-1873
Mailing address
7603 Wildwood CT Apt C1
Lorton, VA 22079-1873
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634083200000",
"number": "1639831951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7603 WILDWOOD CT APT C1",
"city": "LORTON",
"state": "VA",
"postal_code": "220791873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7603 WILDWOOD CT APT C1",
"city": "LORTON",
"state": "VA",
"postal_code": "220791873",
"telephone_number": "571-639-9754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTRO-MORENO",
"first_name": "JOHANNALY",
"credential": "PSYCH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-13",
"last_updated": "2021-10-13",
"certification_date": "2021-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "PR",
"license": "4597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lorton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.