Active NPI
Kathryn Hanna Brideau, PSY.D.
- Psychologist
- Alexandria, VA
National Provider Identifier
1912376807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 0810005816
- Practice address
- 2016 Mount Vernon Ave Ste 300
Alexandria, VA 22301-1367 - Phone
- (440) 251-0220
- NPI assigned
- Sep 21, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 0810005816 | VA | Primary |
Addresses
Primary practice location
2016 Mount Vernon Ave Ste 300
Alexandria, VA 22301-1367
Mailing address
227 Guthrie Ave
Alexandria, VA 22305-1818
Phone (440) 251-0220
Other practice location 1
102 Heritage Way NE
Suite 302
Leesburg, VA 20176-4544
Phone (703) 771-5100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810005816 | VA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1912376807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "227 GUTHRIE AVE",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223051818",
"telephone_number": "440-251-0220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2016 MOUNT VERNON AVE STE 300",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223011367",
"telephone_number": "440-251-0220"
}
],
"practiceLocations": [
{
"address_1": "102 Heritage Way NE",
"address_2": "Suite 302",
"address_purpose": "LOCATION",
"city": "Leesburg",
"state": "VA",
"postal_code": "201764544",
"country_code": "US",
"telephone_number": "703-771-5100",
"fax_number": "703-777-0170",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRIDEAU",
"first_name": "KATHRYN",
"middle_name": "HANNA",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-21",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "VA",
"license": "0810005816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.