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Organization

SELF KNOWLEDGE BASE AND FOUNDATION

Active
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Organization

SELF KNOWLEDGE BASE AND FOUNDATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHELLE R RAD LCP, PSYD, MA, APIT (FOUNDER, LICENSED CLINICAL PSYCHOLO)
(443) 937-3183
Entity
Organization

Contact information

Practice address
43803 MICHENER DR, ASHBURN, VA 20147-5807
(703) 443-4924
(703) 775-1560
Mailing address
43803 MICHENER DR, ASHBURN, VA 20147-5807
(443) 937-3183
(571) 999-7201

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary

Other

Enumeration date
08/14/2023
Last updated
04/28/2026
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