Provider Demographics
NPI:1396331914
Name:CHOURAESHKENAZI, MONIQUE MARIE (PHD, PSYD, MSCP)
Entity type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:MARIE
Last Name:CHOURAESHKENAZI
Suffix:
Gender:F
Credentials:PHD, PSYD, MSCP
Other - Prefix:DR
Other - First Name:MONIQUE
Other - Middle Name:MARIE
Other - Last Name:CHOURAESHKENAZI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, PSYD, MSCP
Mailing Address - Street 1:8609 WESTWOOD CENTER DR STE 110
Mailing Address - Street 2:
Mailing Address - City:TYSONS CORNER
Mailing Address - State:VA
Mailing Address - Zip Code:22182-7525
Mailing Address - Country:US
Mailing Address - Phone:703-646-0730
Mailing Address - Fax:
Practice Address - Street 1:8609 WESTWOOD CENTER DR STE 110
Practice Address - Street 2:
Practice Address - City:TYSONS CORNER
Practice Address - State:VA
Practice Address - Zip Code:22182-7525
Practice Address - Country:US
Practice Address - Phone:703-646-0730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-17
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities