Active NPI
Jessica Lenore David
- Clinical Psychologist
- Fairfax, VA
National Provider Identifier
1962835637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810008746
- Practice address
- 3554 Chain Bridge Rd Ste 200
Fairfax, VA 22030-2709 - Phone
- (703) 896-7628
- NPI assigned
- Aug 16, 2013
- 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 | 0810008746 | VA | Primary |
Addresses
Primary practice location
3554 Chain Bridge Rd Ste 200
Fairfax, VA 22030-2709
Mailing address
9039 Andromeda Dr
Burke, VA 22015-3507
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 |
|---|---|---|---|
| 0810008746 | VA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairfax Mental Health & Wellness | Clinical | Current | Accepting new patients |
| Family Center Counseling | Clinical | Past | Accepting new patients |
| The Family Center Counseling Associates PLLC | Clinical | Past | Accepting new patients |
Locations
3554 Chain Bridge Rd
Ste 200
Fairfax, VA 22030
Phone (703) 593-2182
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Professional Counselor
- Falls Church, VA
- NPI 1861571507
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734393600000",
"number": "1962835637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9039 ANDROMEDA DR",
"city": "BURKE",
"state": "VA",
"postal_code": "220153507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3554 CHAIN BRIDGE RD STE 200",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220302709",
"telephone_number": "703-896-7628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVID",
"first_name": "JESSICA",
"middle_name": "LENORE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-16",
"last_updated": "2024-12-17",
"certification_date": "2024-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810008746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.