Stephanie Grace Park, PH.D.
NPI 1225490105ActiveIndividual· Psychologist, Clinical· Rockville, MD
Psychologist, Clinical (PH.D.) with Privia Medical Group, LLC, practicing in Rockville, Maryland. Medicare paid $23,229 for services to 43 patients in 2024.
Overview
| NPI | 1225490105 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PH.D. |
| Sole proprietor | No |
| NPI issued | Mar 22, 2016 |
| Last updated in NPPES | Mar 22, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | 05433 | MD |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (DC) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 43 |
|---|---|
| Services billed | 249 across 4 procedure codes |
| Paid by Medicare | $23,229 |
Education and affiliations
| Graduation year | 2014 |
|---|---|
| Medicare specialty | Clinical Psychologist |
| Telehealth | Offers telehealth |
Medical group
- Privia Medical Group, LLCFairfax, VA · 1,533 clinicians
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All 119 clinical psychologists in Rockville · All clinical psychologists in Maryland