Jacqueline Ann Neilson, LCP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810003870 Issued in VA

Practice address

720 N Saint Asaph St
Alexandria, VA 22314-1912

Phone

(703) 838-4455

Fax

(703) 838-5070

NPI assigned

Oct 25, 2007

Last updated

Oct 25, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1710166897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 G ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200023605",
            "telephone_number": "703-838-4455",
            "fax_number": "703-838-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N SAINT ASAPH ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223141912",
            "telephone_number": "703-838-4455",
            "fax_number": "703-838-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEILSON",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "credential": "LCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-25",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003870",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04466",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.