MEDICARE: NURTURED MIND PSYCHOLOGICAL SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1689536443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NURTURED MIND PSYCHOLOGICAL SERVICES LLC

Provider Business Mailing Address
First Line	:	6101 HENRY HOUSE CT
Second Line	:
City	:	FAIRFAX STATION
State	:	VA
Zip	:	22039-1328
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6101 HENRY HOUSE CT
Second Line	:
City	:	FAIRFAX STATION
State	:	VA
Zip	:	22039-1328
Country	:	US
Telephone Number	:	571-230-2399
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	AMBER ROSE MORRIS
Credential	:	PSYD
Telephone Number	:	571-230-2399

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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