Provider Demographics
NPI:1326845462
Name:WOODARD, NICOLE MICHELLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:MICHELLE
Last Name:WOODARD
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 N ST NW APT 914
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-4823
Mailing Address - Country:US
Mailing Address - Phone:305-720-0097
Mailing Address - Fax:
Practice Address - Street 1:10560 ARROWHEAD DR STE 200
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7322
Practice Address - Country:US
Practice Address - Phone:703-865-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008806103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical