NPIMap

Organization Active NPI

Neuropsychology Associates of Fairfax Virginia LLC

  • Clinical Neuropsychologist
  • Fairfax, VA
National Provider Identifier
1679177224
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
NEUROPSYCHOLOGY ASSOCIATES OF FAIRFAX VIRGINIA LLC
Doing business as
Neuropsychology Associates of Fairfax, LLC
Practice address
3020 Hamaker CT Ste 103
Fairfax, VA 22031-2220
Phone
(703) 876-0966
Fax
(703) 876-1628
NPI assigned
Nov 24, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Authorized official

Name
Dr. Cynthia L Sullivan, PHDNPI 1801903000
Title
Owner
Phone
(703) 851-7109

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X Primary

Addresses

Primary practice location

3020 Hamaker CT Ste 103
Fairfax, VA 22031-2220

Mailing address

3020 Hamaker CT Ste 103
Fairfax, VA 22031-2220
Phone (703) 876-0966

Other names 1

  • Neuropsychology Associates of Fairfax, LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210315001500 DC Part B Supplier - Clinic/Group Practice 5597171611 Receives reassigned benefits from 8 practitioners
Practice locations: Fairfax, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606176000000",
    "number": "1679177224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 HAMAKER CT STE 103",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312220",
            "telephone_number": "703-876-0966",
            "fax_number": "703-876-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 HAMAKER CT STE 103",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312220",
            "telephone_number": "703-876-0966",
            "fax_number": "703-876-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROPSYCHOLOGY ASSOCIATES OF FAIRFAX VIRGINIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-24",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-20",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-851-7109",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neuropsychology Associates of Fairfax, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.