Diana Gaydusek
Individual provider Active NPI Psychologist · Clifton, VA
NPI 1982152757 · NPPES record last updated Aug 11, 2021
Key facts
- NPI
- 1982152757
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- Practice address
- 13712 Springstone CT
Clifton, VA 20124-2365 - Phone
- (703) 755-0689
- NPI assigned
- Sep 21, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mind Body Health LLC | Psychologist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Yes |
Addresses
Primary practice location
13712 Springstone CT
Clifton, VA 20124-2365
Mailing address
13712 Springstone CT
Clifton, VA 20124-2365
Phone (518) 369-4723
Other providers in Clifton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.