Therapy Services at the Square, PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

081003919 Issued in VA

Legal business name

THERAPY SERVICES AT THE SQUARE, PLLC

Practice address

11198 Lee Hwy
Ste D2
Fairfax, VA 22030-5008

Phone

(703) 330-3105

Fax

(703) 621-1128

NPI assigned

Oct 28, 2011

Last updated

Oct 28, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lauren Fisher, PSYD

Title

Licensed Clinical Psychologist

Phone

(703) 330-3105

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1319760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319760000000",
    "number": "1649556184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11198 LEE HWY",
            "address_2": "STE D2",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305008",
            "telephone_number": "703-330-3105",
            "fax_number": "703-621-1128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11198 LEE HWY",
            "address_2": "STE D2",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305008",
            "telephone_number": "703-330-3105",
            "fax_number": "703-621-1128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPY SERVICES AT THE SQUARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-28",
        "last_updated": "2011-10-28",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "703-330-3105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "081003919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; 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.