SPORT PSYENCE, LLC (NPI# 1841802816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841802816 |
| Entity Type | Organization |
| Organization Name | SPORT PSYENCE, LLC |
| Practice Address |
5 S Montague St Arlington VA 22204-1007 |
| Practice Telephone | 7035946585 |
| Mailing Telephone | 7035946585 |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2020-08-20 |
| Authorized Official Name | DR. AMBER RONAI CARGILL (LICENSED PSYCHOLOGIST/CEO) |
| Authorized Official Telephone | 7035946585 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TE1100X |
Psychologist Specialization: Exercise & Sports |
Behavioral Health & Social Service Providers | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Street Address |
5 S MONTAGUE ST |
| City | ARLINGTON |
| State | VA |
| Zip Code | 22204-1007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639714157 | Cielito Home Health Services, LLC | Registered Nurse | 3708 3rd. Street South, Arlington, VA 22204 | 2019-11-07 |
| 1275177438 | Annie Rachel Poole | Occupational Therapist | 2301 Columbia Pike, Suite 125, Arlington, VA 22204 | 2019-10-31 |
| 1609426436 | Daniela Patricia Jaldin | Home Health Aide | 3708 3rd St. South, Arlington, VA 22204 | 2019-09-13 |
| 1124581475 | Lisa Nemeth | Psychologist | 2110 Washington Bvld, Office of Student Services, Arlington, VA 22204 | 2019-04-12 |
| 1568946176 | Barcroft Dentistry | Dentist | 939 S. Wakefield St, Arlington, VA 22204 | 2018-09-19 |
| 1316431869 | Shannon Odom | Psychologist | Arlington Public Schools Child Find, 2110 Washington Blvd, Arlington, VA 22204 | 2018-06-19 |
| 1801301106 | Carla Janai Farley | Behavior Technician | 2726 N. Cleveland Street, Arlington, VA 22204 | 2017-12-08 |
| 1174064737 | Ezequiel Andrade Fuentes | Dentist | Calle Segunda #67, Ejido Mariano Matamoros, Tijuana, BAJA CALIFORNIA 22204 | 2017-03-15 |
| 1639583107 | Syeda Kutub | Optometrist | 1020 S Glebe Rd, Arlington, VA 22204 | 2014-06-12 |
| 1255769311 | Joyful Mind Counseling of Virginia | Home Health | 1804 B 9th St South, Arlington, VA 22204 | 2013-10-28 |
| Find all providers in zip 22204 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023640398 | Elise Zamsky | Psychologist | 4539 32nd Rd N, Arlington, VA 22207-4466 | 2020-02-05 |
| 1447881909 | Washington Center for Weight Management and Research | Psychologist | 2800 S Shirlington Rd Ste 505, Arlington, VA 22206-3618 | 2020-02-03 |
| 1477193886 | Aleta Michelle Myers | Psychologist | 2121 N Culpeper St, Arlington, VA 22207-2006 | 2020-01-14 |
| 1316408487 | Integrative Psychology, PC | Psychologist | 5 Water St Ste 5b, Arlington, MA 02476-4807 | 2019-03-29 |
| 1437622073 | David Roger Glass Jr. | Psychologist | 1655 Fort Myer Dr Ste 350, Arlington, VA 22209-3118 | 2019-01-07 |
| 1669944872 | James Sexton | Psychologist | 2690 Clarendon Blvd, Arlington, VA 22201-3840 | 2018-12-28 |
| 1003385543 | Tracy Ann Hoffman | Psychologist | 504 N Thomas St Apt B, Arlington, VA 22203-2488 | 2018-11-14 |
| 1275009235 | Michael Gordon Thompson | Psychologist | 34 Robin Hood Rd, Arlington, MA 02474-1242 | 2018-10-17 |
| 1215430566 | Brooke Lauren Mcginnis | Psychologist | 4401 Fairfax Dr Ste 205, Arlington, VA 22203-1622 | 2018-03-13 |
| 1336500354 | Modesto Jesus Hevia I | Psychologist | 23 Rockmont Rd, Arlington, MA 02474-2928 | 2016-03-18 |
| Find all providers in ARLINGTON | ||||
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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.