FAMILYFIRST PSYCHOLOGICAL SERVICES, PC (NPI# 1912214198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912214198 |
| Entity Type | Organization |
| Organization Name | FAMILYFIRST PSYCHOLOGICAL SERVICES, PC |
| Practice Address |
115 Park St Se Suite 207 Vienna VA 22180-4653 |
| Practice Telephone | 7039389090 |
| Practice Fax Number | 7039389091 |
| Mailing Telephone | 7039389090 |
| Mailing Fax Number | 7039389091 |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2010-09-08 |
| Authorized Official Name | DR. KELLY THEIS (PRESIDENT) |
| Authorized Official Telephone | 7039389090 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
0810003318 | VA | Behavioral Health & Social Service Providers |
| Street Address |
115 PARK ST SE SUITE 207 |
| City | VIENNA |
| State | VA |
| Zip Code | 22180-4653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396739686 | Jeffrey D Huang | Family Medicine | 115 Park St Se, Suite 300, Vienna, VA 22180-4653 | 2005-09-01 |
| 1134675010 | Elizabeth Pavesich | Physical Therapist | 115 Park St Se, Suite 206, Vienna, VA 22180-4653 | 2016-08-30 |
| 1891044566 | Marcia S Mofson | Psychologist | 115 Park St Se, Suite 207, Vienna, VA 22180-4653 | 2012-09-10 |
| 1770713216 | Maria Veltsistas Kanakos | Psychologist | 115 Park St Se, Suite 207, Vienna, VA 22180-4653 | 2009-07-17 |
| 1265690614 | Kathleen Boykin Mcelhaney | Psychologist | 115 Park St Se, Vienna, VA 22180-4653 | 2008-06-01 |
| 1417133398 | Fairfax Radiological Consultants PC | Specialist | 115 Park St Se, Ste 203, Vienna, VA 22180-4653 | 2008-01-10 |
| 1447445655 | Robert Edward Kuga | Dentist | 115 Park St Se, Suite 201, Vienna, VA 22180-4653 | 2007-09-11 |
| 1598959173 | Robert E. Kuga, D.d.s., P.C. | Dentist | 115 Park St Se, Suite 201, Vienna, VA 22180-4653 | 2007-08-28 |
| 1689642050 | Beth Ann Schroeder | Physician Assistant | 115 Park St Se, Ste 300, Vienna, VA 22180 | 2006-03-10 |
| 1306817994 | Marcia Bonnie Kaufman | Psychologist | 115 Park St Se, Suite 207, Vienna, VA 22180-4653 | 2006-01-31 |
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| 1023519386 | Erika Ruiz | Dentist | Ave Miraflores #6439 - A, Tijuana, BAJA CALIFORNIA 22180 | 2018-02-22 |
| 1992220206 | John Alexander | Massage Therapist | 122 Maple Ave W, Vienna, VA 22180 | 2017-08-08 |
| 1548620214 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 2675 Avenir Place, Vienna, VA 22180 | 2016-02-24 |
| 1992163190 | Peter J Mcgarry | Chiropractor | 301 Maple Ave. W. Ste 515, Vienna, VA 22180 | 2016-02-02 |
| 1629479563 | Jaimie Vettichira Samuel | Pediatrics | 100 East St Se Ste 301, Vienna, VA 22180 | 2014-09-10 |
| 1326454562 | N R Emad Dds PC | Dentist | 307 F Maple Ave. W #100, Vienna, VA 22180 | 2014-07-09 |
| 1881020568 | Albert Juan Garcia | Obstetrics & Gynecology | 926 Fairway Dr., N.e., Vienna, VA 22180 | 2013-09-25 |
| 1295174662 | Sallie Twentyman | Social Worker | 129 Park St Ne Ste 12b, Vienna, VA 22180 | 2013-06-19 |
| 1124390992 | Gilda T. Clarke | Counselor | 133 Park St. Ne, Vienna, VA 22180 | 2012-02-08 |
| 1740573898 | Metro Eyes LLC | Technician/Technologist | 256 E Maple Avenue, Vienna, VA 22180 | 2011-05-24 |
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| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790994853 | Carolyn Jackson Sahni | Psychologist | 922 Ninovan Rd Se, Vienna, VA 22180 | 2007-05-22 |
| 1972813467 | Mary Anne Ellis | Psychologist | 133 Park St Ne, Vienna, VA 22180-4602 | 2010-10-18 |
| 1821215609 | Sarah Alice Hover | Psychologist | 380 Maple Ave W, Suite 303, Vienna, VA 22180-5620 | 2007-04-20 |
| 1356463525 | Virginia Smith | Psychologist | 380 Maple Ave W, Suite 303 B, Vienna, VA 22180-5620 | 2007-04-06 |
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| 1083161368 | Nancy Watt Marin | Psychologist | 5060 37th St N, Arlington, VA 22207-1823 | 2016-09-05 |
| 1407221716 | Spectrum Psychological and Neurotherapy PC | Psychologist | 4542 Bonney Rd Ste B, Virginia Beach, VA 23462 | 2015-12-11 |
| 1346613668 | Brian Edward Razzino | Psychologist | 150 Little Falls St Ste 200, Falls Church, VA 22046-4315 | 2015-11-09 |
| 1538597448 | Jadig Garcia | Psychologist | 10571 Telegraph Rd Ste 110, Glen Allen, VA 23059-4652 | 2013-10-31 |
| 1629327226 | Angela Michelle Malo | Psychologist | 11480 Sunset Hills Rd, Reston, VA 20190-5265 | 2012-08-29 |
| 1093092272 | Peter F Cooper | Psychologist | 359 Sherwood Ave, Staunton, VA 24401-4430 | 2011-11-15 |
| 1972889871 | Sara Markese Phd Pllc | Psychologist | 2813 Lee Oaks Ct, Suite 304, Falls Church, VA 22046-7336 | 2011-10-24 |
| 1457644585 | Tara Banks Wallace | Psychologist | 8626 Lee Hwy Ste 200, Fairfax, VA 22031-2135 | 2011-05-23 |
| 1598088502 | Megan F Gerbracht | Psychologist | 1489 Chain Bridge Rd Ste 203, Mc Lean, VA 22101-5724 | 2010-03-04 |
| 1346572351 | Jill Allison Ferrante Gasper | Psychologist | 508 Libbie Ave, Suite 100, Richmond, VA 23226-2618 | 2010-02-02 |
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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.