Richard Conner, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810005476 Issued in VA

Practice address

4320 Prince William Pkwy Ste 109
Woodbridge, VA 22192

Phone

(703) 680-4200

NPI assigned

Nov 3, 2016

Last updated

Jan 17, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1932651247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 PRINCE WILLIAM PKWY STE 109",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221928100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 PRINCE WILLIAM PKWY STE 109",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22192",
            "telephone_number": "703-680-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5691 Columbia Pike",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220412887",
            "country_code": "US",
            "telephone_number": "703-998-5606 x309",
            "fax_number": "703-998-5606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNER",
        "first_name": "RICHARD",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-03",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005476",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "VA",
            "license": "0810005476",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "VA",
            "license": "0810005476",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "VA",
            "license": "0810005476",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "VA",
            "license": "0810005476",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.