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).
| 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 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
0810004822 | VA | Behavioral Health & Social Service Providers |
| Street Address |
5403 CABOT RIDGE CT |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22032-3214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093193567 | Cynthia Leigh Pascal | Counselor | 9801 Joyce Street, Fairfax, VA 22032 | 2015-05-15 |
| 1760888432 | Judy Lim | Massage Therapist | 4205 Olley Ln, Fairfax, VA 22032 | 2014-11-07 |
| 1083015010 | Caring Heart Nursing Services LLC | Registered Nurse | 4824 Gainsborough Dr, Fairfax, VA 22032 | 2014-09-09 |
| 1033483839 | Inovacares for Seniors | PACE Provider Organization | 4027b Olley Lane, Braddock Glen, Fairfax, VA 22032 | 2012-02-27 |
| 1598032716 | Joshua Michael Prozeralik | Pharmacist | 10310 New Guinea Road, Burke, VA 22032 | 2011-11-17 |
| 1356570071 | Azmy A. Iskander | Emergency Medicine | 10520 Acacia Lane, Fairfax, VA 22032 | 2009-07-02 |
| 1851515175 | The Pediatric Group, PC | Registered Nurse | 10527 Braddock Road, Fairfax, VA 22032 | 2007-04-11 |
| 1770634313 | Andrea L Lubeck | Nurse Practitioner | 10301 New Guinea Road, Cvs Health, Minuteclinic, Fairfax, VA 22032 | 2007-01-12 |
| 1104167212 | Inova Health Care Services | PACE Provider Organization | 4027b Olley Lane, Braddock Glen, Fairfax, VA 22032 | 2013-03-14 |
| 1770835993 | Catherine A Groden | Nurse Practitioner | 10301 New Guinea Rd, Target, Fairfax, VA 22032 | 2012-10-11 |
| Find all providers in zip 22032 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| 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 |
| Find all providers in FAIRFAX | ||||
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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.