Individual provider Active NPI

Amanda E Hyde, PSYD

  • Clinical Psychologist
  • Fairfax, VA
National Provider Identifier
1750163457
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810008328 Issued in VA
Practice address
3554 Chain Bridge Rd Ste 200
Fairfax, VA 22030-2709
Phone
(703) 896-7628
NPI assigned
Oct 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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 0810008328 VA Primary

Addresses

Primary practice location

3554 Chain Bridge Rd Ste 200
Fairfax, VA 22030-2709

Mailing address

3100 Beechwood LN
Falls Church, VA 22042-3108
Phone (717) 451-3385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0810008328VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax Mental Health & Wellness Clinical CurrentSince Sep 29, 2024 Accepting new patients

Locations

3554 Chain Bridge Rd
Ste 200
Fairfax, VA 22030
Phone (703) 593-2182

Organizations & group practices 1

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": "1697500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1750163457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 BEECHWOOD LN",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423108",
            "telephone_number": "717-451-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3554 CHAIN BRIDGE RD STE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302709",
            "telephone_number": "703-896-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYDE",
        "first_name": "AMANDA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810008328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 17, 2023; 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.