Child Custody Clinic PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

CHILD CUSTODY CLINIC PLLC

Practice address

6 Pidgeon Hill Dr Ste 190
Sterling, VA 20165-6104

Phone

(703) 973-3863

NPI assigned

Jan 3, 2022

Last updated

Jan 3, 2022By 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

Elizabeth Bennett, PHDNPI 1700181757

Title

Owner

Phone

(703) 973-3863

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth Morgan Bennett, PH.D.

  • Clinical Psychologist
  • Reston, VA
  • NPI 1700181757
  NPD Authorized official

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

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641168000000",
    "number": "1750042669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 WINTERPORT CLUSTER",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913623",
            "telephone_number": "703-973-3863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PIDGEON HILL DR STE 190",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201656104",
            "telephone_number": "703-973-3863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD CUSTODY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-03",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-973-3863",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annie Chen, MS
• Joy Chen
• Mary H Chen
• Cherry Blossom Home Care LLC
• Georgina Rose Chidaushe, NP
• Gyeong Young Cho
• Jeff Chuh, O.D.
• Jordan Marie Claggett
• Joanna Claustro, D.M.D.
• Matthew Ryan Clay

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.