Individual provider Active NPI

Alexis Melville, PSY.D.

  • Clinical Psychologist
  • Fairfax, VA
National Provider Identifier
1699232173
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
810005503 Issued in VA
Practice address
4094 Majestic LN Unit 315
Fairfax, VA 22033-2104
Phone
(860) 796-4553
NPI assigned
Feb 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 810005503 VA Primary
Clinical Psychologist 103TC0700X 004690 CT

Addresses

Primary practice location

4094 Majestic LN Unit 315
Fairfax, VA 22033-2104

Mailing address

263 Farmington Ave
Farmington, CT 06030-8082
Phone (860) 679-6700

Other practice location 1

263 Farmington Ave
Farmington, CT 06030-1410
Phone (860) 679-6700

Other practice location 2

10 Talcott Notch Rd
Farmington, CT 06032-1800
Phone (860) 679-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260116002006 CT Practitioner - Clinical Psychologist 8224515523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Nova Southeastern College of Osteo Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004690CTMDClinical Psychologist
810005503VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Feb 1, 2026 Accepting new patients
State of Connecticut CurrentSince Feb 1, 2026 Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

10 Talcott Notch Rd
Farmington, CT 06032
Phone (860) 679-6700

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1699232173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060308082",
            "telephone_number": "860-679-6700",
            "fax_number": "860-679-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4094 MAJESTIC LN UNIT 315",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332104",
            "telephone_number": "860-796-4553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060301410",
            "country_code": "US",
            "telephone_number": "860-679-6700",
            "fax_number": "860-679-6736",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Talcott Notch Rd",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060321800",
            "country_code": "US",
            "telephone_number": "860-679-6700",
            "fax_number": "860-679-6736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELVILLE",
        "first_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-21",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "810005503",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "004690",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.