TANISHA S BRACEY


Address: 5403 Cabot Ridge Ct, Fairfax, VA 22032-3214
Phone: 2022779687

TANISHA S BRACEY (NPI# 1912348343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912348343
Entity Type Individual
Full Name TANISHA S BRACEY
Practice Address 5403 Cabot Ridge Ct
Fairfax
VA 22032-3214
Practice Telephone 2022779687
Practice Fax Number 7032503782
Mailing Telephone 2022779687
Mailing Fax Number 7032503782
Enumeration Date 2013-07-15
Last Update Date 2014-05-07
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
0810004822 VA Behavioral Health & Social Service Providers

Office Location

Street Address 5403 CABOT RIDGE CT
City FAIRFAX
State VA
Zip Code 22032-3214

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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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
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
1215187281 Audiovisual Healthcare Services LLC Psychologist 3559 Plum Dale Dr, Fairfax, VA 22033-1250 2008-09-25
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Competitor

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City FAIRFAX
Zip Code 22032

Improve Information

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Dataset Information

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.

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