Provider Demographics
NPI:1457137440
Name:SCOPELLITI, KATIE MARIE (DOCTOR OF PSYCHOLOGY)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:MARIE
Last Name:SCOPELLITI
Suffix:
Gender:F
Credentials:DOCTOR OF PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9912 KINGSBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-1613
Mailing Address - Country:US
Mailing Address - Phone:570-394-1902
Mailing Address - Fax:
Practice Address - Street 1:1600 DUKE ST STE 350
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-3466
Practice Address - Country:US
Practice Address - Phone:703-618-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0810008611103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical