Kelly Heiges Theis, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

081003318 Issued in VA

Practice address

8381 Old Courthouse Road
Suite 330
Vienna, VA 22182-1670

Phone

(703) 938-9090

Fax

(703) 938-9091

NPI assigned

Sep 15, 2006

Last updated

Sep 1, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 7, 2017 through Mar 7, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Familyfirst Psychological Services, PC

  • Clinical Child & Adolescent Psychologist
  • Vienna, VA
  • NPI 1912214198
  Authorized official Same address or phone

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1811093149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 ALDENHAM LN",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903901",
            "telephone_number": "703-864-5416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8381 OLD COURTHOUSE ROAD",
            "address_2": "SUITE 330",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221821670",
            "telephone_number": "703-938-9090",
            "fax_number": "703-938-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEIS",
        "first_name": "KELLY",
        "middle_name": "HEIGES",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "081003318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "89130026",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "541598045",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010099072",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "293937",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "541598045",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM HK",
            "identifier": "139309",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7751599",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "715692000",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Reading and Language Learning Center
• The Retina Group of Washington, PLLC
• The Ross Center of Northern Virginia, PLLC
• The Vienna Hearing Center, Inc.
• The Vision of Hope Foundation (Nuvision Eyecare Center)
• Jacqueline Thelen
• Susan Theon, LCSW, MSW
• Dwayne Thigpen
• Thomas Acupuncture Inc
• Nathan Prescott Thomas Jr.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.