Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Stephanie Grace Park, PHD

Individual provider Clinical Psychologist · NPI 1225490105

Dr. Stephanie Grace Park, PHD is a Clinical Psychologist in Rockville, Maryland. Qualified in 2014, 12 years ago. Practices with Privia Medical Group, LLC, a 1,518-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Maryland.

Years since qualifying
12
Licensed in
MD
In the registry since
2016
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

1201 Seven Locks Rd Ste 111
Rockville, MD 20854-2931
Phone: (301) 762-5020
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 05433 (MD)

Record details

NPI number1225490105
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorNo
NPI enumeratedMarch 22, 2016
Last updated in NPPESMarch 22, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Privia Medical Group, Llc — 1518 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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