DR. CAROL WILLIAMS NICKELSON (NPI# 1922637982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922637982 |
| Entity Type | Individual |
| Full Name | DR. CAROL WILLIAMS NICKELSON |
| Other Name | CAROL WILLIAMS |
| Credential | PSYD |
| Practice Address |
20925 Professional Plz Ste 230 Ashburn VA 20147-3403 |
| Mailing Address |
21385 Glebe View Dr Broadlands VA 20148-3629 |
| Practice Telephone | 7036217121 |
| Mailing Telephone | 7037230119 |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2020-10-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
0810007253 | VA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 21385 Glebe View Dr, Broadlands, VA 201483629 | 7037230119 |
| Street Address |
20925 PROFESSIONAL PLZ STE 230 |
| City | ASHBURN |
| State | VA |
| Zip Code | 20147-3403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336235407 | Ruth Sumathi Stephen | Psychologist | 20925 Professional Plz Ste 230, Ashburn, VA 20147-3403 | 2006-10-05 |
| 1184032476 | Ann Carnes | Nurse Practitioner | 20925 Professional Plz Ste 230, Ashburn, VA 20147-3403 | 2014-07-30 |
| 1578904702 | Atlantic Counseling Group | Psychologist | 20925 Professional Plz Ste 230, Ashburn, VA 20147-3403 | 2013-07-16 |
| 1861547374 | Alexandra Hilton | Psychologist | 20925 Professional Plz Ste 230, Ashburn, VA 20147-3403 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750982039 | Smita J Patel | Pharmacist | 43614 Millay Ct., Ashburn, VA 20147 | 2020-11-04 |
| 1740812205 | Ericka N Schmitt | Psychologist | Interchange Psychology, 44075 Pipeline Plaza, Ashburn, VA 20147 | 2020-02-12 |
| 1164065967 | Dorsa Salehi | Behavior Technician | 44933 George Washing Blvd, Suite 115, Ashburn, VA 20147 | 2019-10-24 |
| 1659837094 | Sandrine Shanghai | Case Management | 44933 George Washington Parkway, Suite 110, Ashburn, VA 20147 | 2019-02-11 |
| 1033684154 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 44835 Russel Branch Parkway, Ashburn, VA 20147 | 2018-10-04 |
| 1417437203 | Roshni A Patel | Optometrist | 44050 Ashburn Village Blvd, Suite 163, Ashburn, VA 20147 | 2018-08-21 |
| 1972095974 | Verum Cutis Dermatology | Dermatology | 44110 Ashburn Shopping Plz Unit 237, Ashburn, VA 20147 | 2018-06-05 |
| 1033608542 | Justin Leeman | Physical Therapist | 21625 Red Rum Dr, Ashburn, VA 20147 | 2018-05-09 |
| 1255860680 | Aperiomics, Inc. | Clinical Medical Laboratory | 45085 University Dr, Ste 305, Ashburn, VA 20147 | 2017-06-08 |
| 1427591643 | Monecia Michelle Nelms | Counselor | 20925 Professional Plaza, Suite #320, Ashburn, VA 20147 | 2016-11-19 |
| Find all providers in zip 20147 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710593603 | Tina Tehrani Nawaz | Psychologist | 23909 Heather Meadow Dr, Ashburn, VA 20148-1767 | 2020-09-16 |
| 1720459746 | Michelle Rad | Psychologist | 43803 Michener Dr, Ashburn, VA 20147-5807 | 2015-10-16 |
| 1457653156 | Stacey Lefing | Psychologist | 21001 Sycolin Rd Ste 360, Ashburn, VA 20147 | 2010-12-01 |
| 1851627962 | Pinnacle Behavioral Health | Psychologist | 20915 Ashburn Road, Suite 200, Ashburn, VA 20147 | 2009-10-23 |
| 1225362734 | Albert Jerome | Psychologist | 44110 Ashburn Shopping Plaza, Ashburn, VA 20147 | 2009-09-30 |
| 1194930248 | Kathleen Diane Kozma | Psychologist | 20604 Gordon Park Sq, #190, Ashburn, VA 20147-3143 | 2007-05-11 |
| 1467588558 | Martha Jane Merrion | Psychologist | 20130 Lakeview Center Plz Fl 4, Ashburn, VA 20147-5904 | 2007-02-26 |
| 1144360157 | Karen Kingsley, Ph.d. | Psychologist | 22563 Forest Manor Dr, Ashburn, VA 20148-6900 | 2007-02-07 |
| 1336235407 | Ruth Sumathi Stephen | Psychologist | 20925 Professional Plz Ste 230, Ashburn, VA 20147-3403 | 2006-10-05 |
| 1841395654 | Patrick Joseph Nisco II | Psychologist | 20905 Professional Plaza, Suite 220, Ashburn, VA 20147 | 2006-09-14 |
| Find all providers in ASHBURN | ||||
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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.