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LISA KLEWICKI PH.D.
NPI 1265989503
Psychologist - Clinical in Falls Church, VA

Active since September 03, 2016Opted out of Medicare · through Jun 14, 2028
450 W BROAD ST STE 211, FALLS CHURCH, VA 22046(571) 277-4919(703) 241-1122 Get Directions Write a Review

NPPES record last updated: September 3, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Lisa Klewicki Ph.d. NPPES

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

LISA KLEWICKI PH.D. (NPI 1265989503) is an individual clinical provider in Falls Church, Virginia, licensed in Virginia (0810002980) and active in the NPI registry since September 2016. She has opted out of Medicare through June 14, 2028.

NPPES Registry Identity

NPI1265989503
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameLISA KLEWICKICredential: PH.D.
Location Address450 W BROAD ST STE 211Falls Church, VA 22046-3318
Mailing Address450 W Broad St Ste 211Falls Church, VA 22046-3318 · (571) 277-4919 · Fax (703) 241-1122
Phone(571) 277-4919
Fax(703) 241-1122
Sole ProprietorYes
Enumeration DateSeptember 3, 2016
✔ NPI 1265989503 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 · 0810002980
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.
450 W BROAD ST STE 211, Falls Church, VA 22046
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Lisa Klewicki Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 14, 2024 through June 14, 2028.

Opt-Out Effective DateJune 14, 2024
Opt-Out In Effect ThroughJune 14, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FOUNTAIN OF LIFE LLC
Psychologist (Clinical)
450 W BROAD ST STE 211
FALLS CHURCH, VA 22046
Falls Church City (571) 277-4919

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 Lisa Klewicki's NPI number?

The NPI number for Lisa Klewicki is 1265989503. It was assigned to this individual provider in the NPPES registry on September 3, 2016.

Where is Lisa Klewicki located?

Lisa Klewicki practices at 450 W Broad St Ste 211, Falls Church, VA 22046. The listed phone number is (571) 277-4919.

What is Lisa Klewicki's specialty?

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

Is Lisa Klewicki enrolled in Medicare?

No. Lisa Klewicki has opted out of Medicare through June 14, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Lisa Klewicki was last updated on September 3, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.