Active NPI
Brooke Tancer Kahn, PSY.D.
- Clinical Psychologist
- Vienna, VA
National Provider Identifier
1942624267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810004914
- Practice address
- 133 Park St NE
Vienna, VA 22180-4602 - Phone
- (703) 281-4928
- NPI assigned
- Feb 6, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810004914 | VA | Primary |
Addresses
Primary practice location
133 Park St NE
Vienna, VA 22180-4602
Mailing address
133 Park St NE
Vienna, VA 22180-4602
Phone (703) 281-4928
Other names 1
- Brooke Jennifer Tancer
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2024 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391644800000",
"number": "1942624267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 PARK ST NE",
"city": "VIENNA",
"state": "VA",
"postal_code": "221804602",
"telephone_number": "703-281-4928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 PARK ST NE",
"city": "VIENNA",
"state": "VA",
"postal_code": "221804602",
"telephone_number": "703-281-4928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAHN",
"first_name": "BROOKE",
"middle_name": "TANCER",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-06",
"last_updated": "2014-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810004914",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BROOKE",
"last_name": "TANCER",
"middle_name": "JENNIFER",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Vienna, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.