Olivia Soutullo, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY1001541 Issued in DC

Practice address

111 Michigan Ave NW
Washington, DC 20010-2916

Phone

(202) 476-5980

NPI assigned

Oct 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Children's Hospital

  dba Children's National Medical Associates

  • Pediatrics Physician
  • Washington, DC
  • NPI 1780800128
  NPD
• Children's Hospital

  • Children's Hospital
  • Washington, DC
  • NPI 1912939703
  NPD
• Children's Hospital

  dba Children's National Specialty Pharmacy

  • Community/Retail Pharmacy
  • Silver Spring, MD
  • NPI 1326878349
  NPD

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1811539976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 WISCONSIN AVE NW STE 317",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200074104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102916",
            "telephone_number": "202-476-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTULLO",
        "first_name": "OLIVIA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "DC",
            "license": "PSY1001541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DC BOARD OF PSYCHOLOGY",
            "identifier": "PSY1001541",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlette Southerland
• Sandra Marie Southerland
• Southern Radiology Groups
• Gillian Alison Southwell, M.D.
• Suzanne Southworth, PHD
• Ashley Souverain, RN
• Widline Souverain
• Nataliia Sova
• Aissatou Sow
• Jahri Dorinda Sow, PA-C

• Psychologist in Washington, DC
• Providers in Washington, DC by specialty
• Psychologist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.