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

Micah J Park, MD

Individual provider Psychiatry Physician · NPI 1659994473

Micah J Park, MD is a Psychiatry in Lansdowne, Virginia. Qualified in 2020, 6 years ago. Works from 2 locations. Licensed in Virginia.

Years since qualifying
6
Licensed in
VA
In the registry since
2020
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

19420 Golf Vista Plz Ste 250
Lansdowne, VA 20176-8267
Phone: (804) 207-6737
Fax: (703) 665-7686
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1100 Alabama Ave Se, Washington, DC 20032-4542 — (202) 299-5334

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 0101281727 (VA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1659994473
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 27, 2020
Last updated in NPPESApril 29, 2026
Certification dateApril 29, 2026

Medicare enrollment

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

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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