Healthcare Provider Details

I. General information

NPI: 1083192579
Provider Name (Legal Business Name): PSYCHOLOGICAL WELLNESS SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2018
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1489 CHAIN BRIDGE RD STE 300
MC LEAN VA
22101-5724
US

IV. Provider business mailing address

1489 CHAIN BRIDGE RD STE 300
MC LEAN VA
22101-5724
US

V. Phone/Fax

Practice location:
  • Phone: 203-819-7782
  • Fax:
Mailing address:
  • Phone: 203-819-7782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810005064
License Number StateVA

VIII. Authorized Official

Name: DR. COURTNEY FREIMAN
Title or Position: OWNER
Credential: PSY.D., LCP
Phone: 203-470-7760