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

Individual provider Community/Behavioral Health Agency · NPI 1073208070

Gueorgui Klissourov, PHD is a Community/Behavioral Health Agency in Ashburn, Virginia. Practices as a sole proprietor. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
2
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

20116 Ashbrook Pl
Ashburn, VA 20147-5086
Phone: (540) 630-1211
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X
Community/Behavioral Health Agency Taxonomy 251S00000X

Record details

NPI number1073208070
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedApril 6, 2023
Last updated in NPPESJuly 27, 2023
Certification dateJuly 27, 2023

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