Washinton Neuropsychology Research Group, LLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

0810003702 Issued in VA

Legal business name

WASHINTON NEUROPSYCHOLOGY RESEARCH GROUP, LLC

Practice address

3020 Hamaker CT
Suite 103
Fairfax, VA 22031-2238

Phone

(703) 876-0966

Fax

(703) 876-1628

NPI assigned

Dec 9, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Adam Wilken, PH.D.

Title

President

Phone

(703) 876-0966

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1260316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260316800000",
    "number": "1902135684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 OAKTON GLEN DR",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221815344",
            "telephone_number": "703-876-0966",
            "fax_number": "703-876-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 HAMAKER CT",
            "address_2": "SUITE 103",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312238",
            "telephone_number": "703-876-0966",
            "fax_number": "703-876-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINTON NEUROPSYCHOLOGY RESEARCH GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-09",
        "last_updated": "2009-12-09",
        "status": "A",
        "authorized_official_last_name": "WILKEN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-876-0966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "VA",
            "license": "0810003702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Washington Radiology Associates, PLLC
• Washington Speech-Language Pathology Group PLLC
• Washington Vascular Specialists of Fairfax
• Cherelle Monea' Washington, MSW, LCSW
• Lauren Washington, BT
• Abdirisak Wasuge
• Julia Housley Waterman, M.ED., CCC-SLP
• Rebecca Suzanne Marie Waters, PNP-PC
• Katherine L Watkins, LCSW
• Rachael Renee Watkins

• Clinical Neuropsychologist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Clinical Neuropsychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; 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.