Organization · Type 2 NPI

Self Knowledge Base and Foundation

Clinical Psychologist · Ashburn, VA

NPI number 1780467993 Active

Practice location

43803 Michener Dr
Ashburn, VA 20147-5807

Fax (703) 775-1560

Specialties and licenses

TaxonomyCodeLicense
Clinical Psychologist Primary 103TC0700XNone listed

Clinical Psychologist: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of discip…

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About NPI 1780467993

Self Knowledge Base and Foundation's National Provider Identifier is 1780467993, issued on Aug 14, 2023. The primary taxonomy on file is Clinical Psychologist (103TC0700X), and the practice location is in Ashburn, VA. The record was last updated on Apr 28, 2026.