MR. NATHAN JOHN EDMUNDSON (NPI# 1861688384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861688384 |
| Entity Type | Individual |
| Full Name | MR. NATHAN JOHN EDMUNDSON |
| Credential | PSYD |
| Practice Address |
118 E Del Ray Ave Alexandria VA 22301 |
| Mailing Address |
306 1/2 E Del Ray Ave Alexandria VA 22301-1234 |
| Practice Telephone | 7033486427 |
| Mailing Telephone | 6266657582 |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2018-07-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PSY29380 | CA | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
0810005996 | VA | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
0004017 | CO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 36550264 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 118 E Del Ray Ave, Alexandria, VA 223011324 | 7033486427 | |
| 1300 Oliver Rd Ste 193, Fairfield, CA 945343431 | 7075145812 | |
| 306 1/2 E Del Ray Ave, Alexandria, VA 223011234 | 2022500287 | |
| 309 E Saint Vrain St, Colorado Springs, CO 809031123 | 7194739200 |
| Street Address |
118 E DEL RAY AVE |
| City | ALEXANDRIA |
| State | VA |
| Zip Code | 22301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649751405 | Paige Elise Cantfil | Nurse Practitioner | 415 Monroe Ave, Alexandria, VA 22301 | 2018-08-28 |
| 1194267021 | Sedationmd Inc | Anesthesiology | 2111 Main Line Blvd, Alexandria, VA 22301 | 2016-11-09 |
| 1831549799 | Amy Howard | Counselor | 118 East Del Ray Avenue, #8, Alexandria, VA 22301 | 2016-06-21 |
| 1508260316 | Krystal Patel | Pharmacist | 1517 Mt. Vernon Ave, Alexandria, VA 22301 | 2014-10-22 |
| 1548680317 | Kelsey Marie Sanford | Anesthesiology | 519 E Luray Ave, Alexandria, VA 22301 | 2014-04-21 |
| 1609201540 | Patricio Penaherrera | Student in an Organized Health Care Education/Training Program | 89440 Old Keene Mill Road, Springfield, VA 22301 | 2013-09-11 |
| 1861825721 | Karen Nesbit Chaudhry | Social Worker | 8500 Executive Avenue, Suite 204, Fairfax, VA 22301 | 2013-08-14 |
| 1356603922 | Gregory James Cardinal | Podiatrist | 2201 Mount Vernon Ave Ste 105, Alexandria, VA 22301 | 2012-06-11 |
| 1588948137 | Carol Ann Whitmire | Acupuncturist | 2101 Mt. Vernon Ave., Alexandria, VA 22301 | 2011-09-30 |
| 1477835569 | Genesis Rehab Services | Nursing Facility/Intermediate Care Facility | 200 W Uhler Ter, Alexandria, VA 22301 | 2011-09-14 |
| Find all providers in zip 22301 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548886674 | Anita L Boss | Psychologist | 1200 Prince St, Alexandria, VA 22314-2936 | 2020-06-24 |
| 1831722313 | Alexandria Therapy, LLC | Psychologist | 2210 Mount Vernon Ave Ste 204, Alexandria, VA 22301-1361 | 2020-02-12 |
| 1982236709 | Pivotal Psych Consultants | Psychologist | 500 N Washington St Ste 205, Alexandria, VA 22314-2314 | 2020-02-10 |
| 1992337273 | Jessica Mae Desalu | Psychologist | 205 S Whiting St Ste 312, Alexandria, VA 22304-3632 | 2020-02-05 |
| 1760948095 | Daniela Sosa-sarkar | Psychologist | 5500 Holmes Run Pkwy Ste C4, Alexandria, VA 22304-2860 | 2019-02-12 |
| 1326504739 | Sadie Doll | Psychologist | 5615k Jackson St, Alexandria, LA 71303-2592 | 2019-02-11 |
| 1972070894 | Ansari and Associates, LLC | Psychologist | 901 N Washington St Ste 601, Alexandria, VA 22314-1535 | 2018-10-29 |
| 1679040851 | Kathryn Ziemer | Psychologist | 1202 Prince St, Alexandria, VA 22314-2936 | 2018-10-25 |
| 1699259812 | Travis Drake Flower | Psychologist | 3412 Tennessee Dr, Alexandria, VA 22303-1225 | 2018-09-24 |
| 1720572076 | Michele Klopner | Psychologist | 3602 Forest Dr, Alexandria, VA 22302-1091 | 2018-06-20 |
| Find all providers in ALEXANDRIA | ||||
| City | ALEXANDRIA |
| Zip Code | 22301 |
Please comment or provide details below to improve the information on MR. NATHAN JOHN EDMUNDSON.
| 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.