NPIMap

Organization Active NPI

Engebretson Psychology, LLC

  • Clinical Psychologist
  • McLean, VA
National Provider Identifier
1811172026
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810003165 Issued in VA
Legal business name
ENGEBRETSON PSYCHOLOGY, LLC
Practice address
7927 Jones Branch Dr
Suite #6125
MC Lean, VA 22102-3322
Phone
(571) 633-0600
Fax
(703) 992-0993
NPI assigned
Jan 7, 2008
Last updated
Jan 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

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

Authorized official

Name
Dr. Tilmer O. Engebretson, PH.D.NPI 1780869149
Title
Owner
Phone
(571) 633-0600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 0810003165 VA
Clinical Psychologist 103TC0700X 0810003165 VA Primary
Health Psychologist 103TH0004X 0810003165 VA

Addresses

Primary practice location

7927 Jones Branch Dr
Suite #6125
MC Lean, VA 22102-3322

Mailing address

7927 Jones Branch Dr
Suite #6125
MC Lean, VA 22102-3322
Phone (571) 633-0600

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421798400000",
    "number": "1811172026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7927 JONES BRANCH DR",
            "address_2": "SUITE #6125",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023322",
            "telephone_number": "571-633-0600",
            "fax_number": "703-992-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7927 JONES BRANCH DR",
            "address_2": "SUITE #6125",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023322",
            "telephone_number": "571-633-0600",
            "fax_number": "703-992-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENGEBRETSON PSYCHOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2015-01-21",
        "status": "A",
        "authorized_official_last_name": "ENGEBRETSON",
        "authorized_official_first_name": "TILMER",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-633-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "VA",
            "license": "0810003165",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003165",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "VA",
            "license": "0810003165",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.