# PRIVIA MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245176866
- **Authorized official:** BRIANNA FOULKROD (AVP, CRED & ENROLLMENT)
- **Authorized official phone:** (571) 650-2710

## Contact information

- **Practice address:** 9093 RIDGEFIELD DR STE 104, FREDERICK, MD 21701-6711
- **Practice address phone:** (240) 956-5475
- **Mailing address:** 950 N GLEBE RD STE 700, ARLINGTON, VA 22203-4173
- **Mailing address phone:** (800) 973-1442

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/27/2026
- **Last updated:** 04/27/2026