Individual provider Active NPI

Lindsey Berisha

  • Clinical Psychologist
  • Arlington, VA
National Provider Identifier
1902140866
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810006047 Issued in VA
Practice address
4401 Fairfax Dr Ste 205
Arlington, VA 22203-1622
Phone
(571) 328-7408
NPI assigned
Nov 16, 2012
Last updated
Aug 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810006047 VA Primary

Addresses

Primary practice location

4401 Fairfax Dr Ste 205
Arlington, VA 22203-1622

Mailing address

4401 Fairfax Dr Ste 205
Arlington, VA 22203-1622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 29, 2021 through Nov 29, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0810006047VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Body Health LLC CurrentSince Aug 8, 2021 Accepting new patients

Locations

4401 Fairfax Dr
Ste 205
Arlington, VA 22203
Phone (571) 328-7408

Organizations & group practices 1

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": "1353024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1902140866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 FAIRFAX DR STE 205",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 FAIRFAX DR STE 205",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031622",
            "telephone_number": "571-328-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERISHA",
        "first_name": "LINDSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-16",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810006047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.