Individual provider Active NPI

Kathryn Hanna Brideau, PSY.D.

  • Psychologist
  • Alexandria, VA
National Provider Identifier
1912376807
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0810005816 Issued in VA
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

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
0810005816VAMDPsychologist

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.

Verify at the official NPI Registry.