Provider Demographics
NPI:1851614804
Name:JOSEPH, NICOLE C (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:C
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8618 WESTWOOD CENTER DR
Mailing Address - Street 2:SUITE 430
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2222
Mailing Address - Country:US
Mailing Address - Phone:703-772-7822
Mailing Address - Fax:
Practice Address - Street 1:8618 WESTWOOD CENTER DR
Practice Address - Street 2:SUITE 430
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2222
Practice Address - Country:US
Practice Address - Phone:703-772-7822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004197103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist