Healthcare Provider Details

I. General information

NPI: 1700647146
Provider Name (Legal Business Name): JESSENIA WINSTANLEY, PSYD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 WILSON BLVD STE 520
ARLINGTON VA
22209-2419
US

IV. Provider business mailing address

1530 WILSON BLVD STE 520
ARLINGTON VA
22209-2419
US

V. Phone/Fax

Practice location:
  • Phone: 703-810-0321
  • Fax: 703-659-6122
Mailing address:
  • Phone: 703-810-0321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JESSENIA WINSTANLEY
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSYD
Phone: 703-810-0321