OLD TOWN PROFESSIONAL PSYCHOLOGY
NPI 1366063992
Psychologist - Clinical in Alexandria, VA
About Old Town Professional Psychology NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
OLD TOWN PROFESSIONAL PSYCHOLOGY (NPI 1366063992) is a healthcare organization registered as a clinical in Alexandria, Virginia and active in the NPI registry since May 2020. The organization lists Sundar Cook, Psychologist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Old Town Professional Psychology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Old Town Professional Psychology, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Old Town Professional Psychology's NPI number?
The NPI number for Old Town Professional Psychology is 1366063992. It was assigned to this organization in the NPPES registry on May 5, 2020.
Where is Old Town Professional Psychology located?
Old Town Professional Psychology is located at 411 1/2 N Washington St, Alexandria, VA 22314. The listed phone number is (571) 327-0194.
What is Old Town Professional Psychology's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Old Town Professional Psychology enrolled in Medicare?
Yes. Old Town Professional Psychology is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Old Town Professional Psychology?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Old Town Professional Psychology. 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 Old Town Professional Psychology was last updated on May 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Old Town Professional Psychology · NPI 1366063992
Clinical organization in Alexandria, Virginia. Organization record, active in the CMS NPPES registry since May 5, 2020.
## Identity
- **NPI:** 1366063992 (Entity type: Organization)
- **Enumerated:** May 5, 2020
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **Organization subpart:** No
- **Authorized official:** Sundar Cook, PSYCHOLOGIST
## Practice location
- **Address:** 411 1/2 N WASHINGTON ST, Alexandria, VA 22314-2311
- **Phone:** (571) 327-0194
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Clinical Psychologist) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 13, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1366063992) · Data from the CMS NPPES public registry.