Individual provider Active NPI

Annika Grangaard, PSYD

  • Clinical Psychologist
  • Vienna, VA
National Provider Identifier
1689273377
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSYA00300 Issued in DC
Practice address
1595 Spring Hill Rd Ste 520
Vienna, VA 22182-4101
Phone
(703) 687-6610
NPI assigned
Oct 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSYA00300 DC Primary

Addresses

Primary practice location

1595 Spring Hill Rd Ste 520
Vienna, VA 22182-4101

Mailing address

2144 California St NW Apt 512
Washington, DC 20008-1823

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 21, 2022 through Feb 21, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSYA00300DCMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1689273377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2144 CALIFORNIA ST NW APT 512",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200081823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 SPRING HILL RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221824101",
            "telephone_number": "703-687-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGAARD",
        "first_name": "ANNIKA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSYA00300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

Verify at the official NPI Registry.