Individual provider Active NPI

Virginia Ann Gutman, PH.D.

  • Psychologist
  • Alexandria, VA
National Provider Identifier
1649498809
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0810001537 Issued in VA
Practice address
1225 Martha Custis Dr
C-2
Alexandria, VA 22302-2000
Phone
(703) 568-3744
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0810001537 VA Primary
Psychologist 103T00000X PSY1094 DC

Addresses

Primary practice location

1225 Martha Custis Dr
C-2
Alexandria, VA 22302-2000

Mailing address

2709 Central Ave
Alexandria, VA 22302-2811
Phone (703) 568-3744

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY1094DCMDPsychologist
0810001537VAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649498809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 CENTRAL AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223022811",
            "telephone_number": "703-568-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 MARTHA CUSTIS DR",
            "address_2": "C-2",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223022000",
            "telephone_number": "703-568-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTMAN",
        "first_name": "VIRGINIA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810001537",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "DC",
            "license": "PSY1094",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.