Healthcare Provider Details
I. General information
NPI: 1548940141
Provider Name (Legal Business Name): EXPAND PSYCHOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/19/2023
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 N WASHINGTON ST SUITE 202
FALLS CHURCH VA
22046-3441
US
IV. Provider business mailing address
300 N WASHINGTON ST SUITE 202
FALLS CHURCH VA
22046-3441
US
V. Phone/Fax
- Phone: 703-618-0900
- Fax:
- Phone: 703-618-0900
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TA0700X |
| Taxonomy | Adult Development & Aging Psychologist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TB0200X |
| Taxonomy | Cognitive & Behavioral Psychologist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ERIN
KATHLEEN
O'MEARA
Title or Position: DIRECTOR
Credential: PSY.D.
Phone: 571-228-2965