CMS-1500 Box 24J / 33a • NPI
1396331914
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
103G00000X
Licensed & Credentialed Clinical Neuropsychologist
Box 32 Service Location & ZIP+4
8609 WESTWOOD CENTER DR STE 110, TYSONS CORNER, VA, 22182-7525
✓ 9-Digit EDI 837 ZIP+4 (22182-7525)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1396331914 (MONIQUE MARIE CHOURAESHKENAZI, PhD, PsyD, MSCP) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1396331914 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | MONIQUE MARIE CHOURAESHKENAZI, PhD, PsyD, MSCP |
| Plain-English Specialty | Licensed & Credentialed Clinical Neuropsychologist NUCC Code: 103G00000X (Clinical Neuropsychologist) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 8609 WESTWOOD CENTER DR STE 110, TYSONS CORNER, VA, 22182-7525 |
| Practice Telephone / Fax | Tel: (703) 646-0730 |
| Administrative Mailing Address | 8609 WESTWOOD CENTER DR STE 110, TYSONS CORNER, VA, 22182-7525 |
| Enumeration & Last Sync | Enumerated: 2020-12-17 | CMS Record Updated: 2025-10-03 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (103G00000X)
What Does Taxonomy Code 103G00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103G00000X translates to:
"Licensed & Credentialed Clinical Neuropsychologist"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (MONIQUE MARIE CHOURAESHKENAZI, PhD, PsyD, MSCP)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
103TB0200X — Psychologist, Cognitive & BehavioralPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Cognitive & Behavioral | State: N/A | License: Verified | Primary: Secondary |
103TF0200X — Psychologist, ForensicPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Forensic | State: N/A | License: Verified | Primary: Secondary |
103G00000X — Clinical NeuropsychologistPlain English: Licensed & Credentialed Clinical Neuropsychologist | State: N/A | License: Verified | Primary: Yes (Primary) |
103T00000X — PsychologistPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist | State: N/A | License: Verified | Primary: Secondary |
103TM1800X — Psychologist, Intellectual & Developmental DisabilitiesPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Intellectual & Developmental Disabilities | State: N/A | License: Verified | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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