SHERYL KONGSTVEDT (NPI# 1356731822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356731822 |
| Entity Type | Individual |
| Full Name | SHERYL KONGSTVEDT |
| Credential | PHD |
| Practice Address |
3022 Williams Dr Suite 300 Fairfax VA 22031-4600 |
| Practice Telephone | 7035739800 |
| Practice Fax Number | 7035732959 |
| Mailing Telephone | 7035739800 |
| Mailing Fax Number | 7035732959 |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2015-02-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
0810001880 | VA | Behavioral Health & Social Service Providers |
| Street Address |
3022 WILLIAMS DR SUITE 300 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22031-4600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740253020 | Peter Lee Jr. | Pediatrics | 3022 Williams Dr, Suite 301, Fairfax, VA 22031-4600 | 2006-02-08 |
| 1316283914 | Christiane Gallen Davenport | Nurse Practitioner | 3022 Williams Dr, Suite 300, Fairfax, VA 22031-4600 | 2012-12-31 |
| 1972860807 | Hematology Oncology Care of Northern Virginia PC | Internal Medicine | 3022 Williams Dr, Suite 100, Fairfax, VA 22031-4600 | 2012-04-17 |
| 1346526191 | Kathleen Rodgers | Dietitian, Registered | 3022 Williams Dr, Suite 300, Fairfax, VA 22031-4600 | 2011-10-25 |
| 1831410497 | Thania Violeta Lamirand | Emergency Medicine | 3022 Williams Dr, Suite 300, Fairfax, VA 22031-4600 | 2010-06-17 |
| 1326279043 | Bhavika Amin | Nurse Practitioner | 3022 Williams Dr, #300, Fairfax, VA 22031-4600 | 2009-07-29 |
| 1538308978 | Candice M. Driscoll | Physician Assistant | 3022 Williams Dr, Suite 300, Fairfax, VA 22031-4600 | 2009-02-09 |
| 1285884007 | Min Jin Jung Detrick | Physician Assistant | 3022 Williams Dr, 300, Fairfax, VA 22031-4600 | 2008-09-29 |
| 1982871588 | Seyeda Masomeh Abedi | Internal Medicine | 3022 Williams Dr, Suite 300, Fairfax, VA 22031-4600 | 2008-05-13 |
| 1225221096 | Washington Radiology Associates, Pllc | Specialist | 3022 Williams Dr, Ste 204, Fairfax, VA 22031-4600 | 2007-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902414105 | Su Jung Kang | Dentist | 9661-c Main Street, Fairfax, VA 22031 | 2020-07-14 |
| 1346896347 | Fuling Guo | Acupuncturist | 3013 James St, Fairfax, VA 22031 | 2019-08-15 |
| 1902458797 | Kayla Callister | Psychologist | 2270 Willow Oaks Corporate Drive, Fairfax, VA 22031 | 2019-07-11 |
| 1790349801 | Fairfax Dental Esthetics | Dentist | 9621 Fairfax Blvd., Fairfax, VA 22031 | 2019-04-24 |
| 1417427675 | Kathryn Yen Ho | Speech-Language Pathologist | 8270 Willow Oaks Corporate Drive Suite 2127, Falls Church, VA 22031 | 2018-11-30 |
| 1932681376 | Joanne Towers | Physician Assistant | 3025 Hamaker Court Suite 300, Fairfax, VA 22031 | 2018-09-01 |
| 1790262020 | S Renee Dennis | Nurse Practitioner | 8316 Arlington Blvd Ste 500, Fairfax, VA 22031 | 2018-07-19 |
| 1013493451 | Elizabeth Joan Dwyer | Physician Assistant | 3023 Hamaker Ct., Suite 500, Fairfax, VA 22031 | 2018-07-18 |
| 1316432669 | Delta Pharm LLC | Pharmacy | 8316 Arlington Blvd Ste 100, Fairfax, VA 22031 | 2018-06-28 |
| 1629567656 | Laura Breeden | Acupuncturist | 3846 Lyndhurst Dr Apt 301, Fairfax, Va, VA 22031 | 2018-05-04 |
| Find all providers in zip 22031 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699232173 | Alexis Melville | Psychologist | 4094 Majestic Ln Unit 315, Fairfax, VA 22033-2104 | 2019-02-21 |
| 1558867333 | Kyoung Deok Baik | Psychologist | 3554 Chain Bridge Rd Ste 103, Fairfax, VA 22030-2709 | 2018-04-02 |
| 1265849822 | Shushan Campbell | Psychologist | 10521 Rosehaven St Ste 100, Fairfax, VA 22030-2877 | 2014-07-16 |
| 1679994867 | Claire Bartick | Psychologist | 9707 Commonwealth Blvd, Fairfax, VA 22032-2824 | 2013-12-15 |
| 1972933364 | Kim Havenner | Psychologist | 10805 Main St Ste 500, Fairfax, VA 22030-4747 | 2013-11-21 |
| 1912348343 | Tanisha S Bracey | Psychologist | 5403 Cabot Ridge Ct, Fairfax, VA 22032-3214 | 2013-07-15 |
| 1477833168 | Leslie Ann Hawkins | Psychologist | 9840 Main St Ste 201, Fairfax, VA 22031-3909 | 2011-08-25 |
| 1982998910 | Barbara G Smith | Psychologist | 11216 Waples Mill Road, Suite 104, Fairfax, VA 22030 | 2011-06-07 |
| 1184918401 | Martina Pavlicek | Psychologist | 11130 Fairfax Blvd Ste 305, Fairfax, VA 22030-5035 | 2011-06-03 |
| 1821303264 | Lianna R Bennett | Psychologist | 3607 Chain Bridge Rd, Ste A, Fairfax, VA 22030-3242 | 2010-08-10 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.