Individual provider Active NPI

Tamela Harrison

  • Psychiatric/Mental Health Nurse Practitioner
  • Woodbridge, VA
National Provider Identifier
1790540458
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AC006402 Issued in MD
Practice address
13537 Pace CT
Woodbridge, VA 22193-3988
Phone
(301) 802-8807
NPI assigned
Feb 20, 2024
Last updated
Dec 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024189094 VA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AC006402 MD Primary

Addresses

Primary practice location

13537 Pace CT
Woodbridge, VA 22193-3988

Mailing address

13537 Pace CT
Woodbridge, VA 22193-3988
Phone (301) 802-8807

Other practice location 1

13219 Executive Park Ter
Germantown, MD 20874-2647
Phone (240) 762-4141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250204001762 VA Practitioner - Certified Clinical Nurse Specialist (CNS) 8325578594 Reassigns benefits to 1 organization
I20251107003532 DC Practitioner - Nurse Practitioner 8325578594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13219 Executive Park Ter
Germantown, MD 20874-2647
Phone (240) 898-5075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AC006402MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sevox Medical Services CurrentSince Oct 1, 2025 Accepting new patients
Holistic Psychiatry and Medical Center LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

13219 Executive Park Ter
Germantown, MD 20874
Phone (240) 898-5075

556 Garrisonville Rd
Ste 210
Stafford, VA 22554
Phone (301) 917-5808

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1790540458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13537 PACE CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221933988",
            "telephone_number": "301-802-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13537 PACE CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221933988",
            "telephone_number": "301-802-8807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13219 Executive Park Ter",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "MD",
            "postal_code": "208742647",
            "country_code": "US",
            "telephone_number": "240-762-4141",
            "fax_number": "240-744-5661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "TAMELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-20",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024189094",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "AC006402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.