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JEANINE R. CARLSON, PHD, LLC
NPI 1144570771
Psychologist - Clinical in Mc Lean, VA

Active since September 11, 2012
1487 CHAIN BRIDGE RD STE 202, MC LEAN, VA 22101(703) 919-0917 Get Directions Write a Review

NPPES record last updated: September 11, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jeanine R. Carlson, Phd, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEANINE R. CARLSON, PHD, LLC (NPI 1144570771) is a healthcare organization registered as a clinical in Mc Lean, Virginia and active in the NPI registry since September 2012. The organization lists Jeanine R Carlson, Owner, as its authorized official.

NPPES Registry Identity

NPI1144570771
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameJEANINE R. CARLSON, PHD, LLC
Location Address1487 CHAIN BRIDGE RD STE 202Mc Lean, VA 22101-5723
Mailing Address1487 Chain Bridge Rd Ste 202Mc Lean, VA 22101-5723 · (703) 919-0917
Phone(703) 919-0917
Organization SubpartNo
Authorized OfficialJeanine R CarlsonOwner · (703) 919-0917
Enumeration DateSeptember 11, 2012
✔ NPI 1144570771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in VA · VA2078
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
1487 CHAIN BRIDGE RD STE 202, Mc Lean, VA 22101
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeanine R. Carlson, Phd, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateDistrict of ColumbiaEnrollment IDO20130509000466Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Jeanine R. Carlson, Phd, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jeanine Carlson, PH.D.
Clinical Psychologist
NPI 1972794642
1487 CHAIN BRIDGE RD SUITE 202
Mc Lean, VA 22101
(703) 919-0917
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeanine R. Carlson, Phd, LLC's NPI number?

The NPI number for Jeanine R. Carlson, Phd, LLC is 1144570771. It was assigned to this organization in the NPPES registry on September 11, 2012.

Where is Jeanine R. Carlson, Phd, LLC located?

Jeanine R. Carlson, Phd, LLC is located at 1487 Chain Bridge Rd Ste 202, Mc Lean, VA 22101. The listed phone number is (703) 919-0917.

What is Jeanine R. Carlson, Phd, LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jeanine R. Carlson, Phd, LLC enrolled in Medicare?

Yes. Jeanine R. Carlson, Phd, LLC is registered in the Medicare PECOS enrollment system.

When is Jeanine R. Carlson, Phd, LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (District of Columbia, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Jeanine R. Carlson, Phd, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Jeanine R. Carlson, Phd, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jeanine R. Carlson, Phd, LLC was last updated on September 11, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.