MEDICARE: DR. JAMIE LEIGH ADLER PH.D.

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	1785-057	WI

General Provider Information

NPI Number	:	1790888337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMIE LEIGH ADLER PH.D.

Provider Business Mailing Address
First Line	:	3903L FAIR RIDGE DR
Second Line	:	PMB 343
City	:	FAIRFAX
State	:	VA
Zip	:	22033-2940
Country	:	US
Telephone Number	:	608-347-4646
Fax Number	:	888-682-8114

Provider Business Practice Location Address
First Line	:	4006 GREGG CT
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22033-2811
Country	:	US
Telephone Number	:	608-347-4646
Fax Number	:	888-682-8114

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	12/11/2025

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