Individual provider Active NPI

Tehila Selzer-Putney, PH.D.

  • Clinical Psychologist
  • Reston, VA
National Provider Identifier
1750465852
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
081-0001374 Issued in VA
Practice address
11363 Sunset Hills Rd
Reston, VA 20190-5205
Phone
(703) 517-4409
Fax
(703) 437-1908
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 081-0001374 VA Primary

Addresses

Primary practice location

11363 Sunset Hills Rd
Reston, VA 20190-5205

Mailing address

1650 Wild Pine Way
Reston, VA 20194-5600
Phone (703) 517-4409

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
081-0001374VAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750465852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 WILD PINE WAY",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201945600",
            "telephone_number": "703-517-4409",
            "fax_number": "703-437-1908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11363 SUNSET HILLS RD",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905205",
            "telephone_number": "703-517-4409",
            "fax_number": "703-437-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELZER-PUTNEY",
        "first_name": "TEHILA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "081-0001374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.