MEDICARE: DR. BRIAN ELIOT ROSEN PSY.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	103T00000X	Psychologist	0810003315	VA
2	103TC0700X	Clinical Psychologist	0810003315	VA
3	103TC2200X	Clinical Child & Adolescent Psychologist	0810003315	VA

General Provider Information

NPI Number	:	1871636217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN ELIOT ROSEN PSY.D.

Provider Business Mailing Address
First Line	:	2919 S WOODLEY ST APT B
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22206-4012
Country	:	US
Telephone Number	:	703-346-0192
Fax Number	:

Provider Business Practice Location Address
First Line	:	411 N WASHINGTON ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-2311
Country	:	US
Telephone Number	:	703-346-0192
Fax Number	:

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

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	09/11/2025

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