THE CHILD & FAMILY COUNSELING GROUP, PLC (NPI# 1306024914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306024914 |
Entity Type | Organization |
Organization Name | THE CHILD & FAMILY COUNSELING GROUP, PLC |
Practice Address |
3959 Pender Dr Suite 320 Fairfax VA 22030-6041 |
Practice Telephone | 7033523822 |
Practice Fax Number | 7033858353 |
Mailing Telephone | 7033523822 |
Mailing Fax Number | 7033858353 |
Enumeration Date | 2008-02-06 |
Last Update Date | 2008-02-06 |
Authorized Official Name | DR. JOHN W WIRES (NEUROPSYCHOLOGIST) |
Authorized Official Telephone | 7033523822 |
Authorized Official Credential | PH.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YM0800X |
Counselor Specialization: Mental Health |
0904006205 | VA | Behavioral Health & Social Service Providers |
N | 101YM0800X |
Counselor Specialization: Mental Health |
0904000808 | VA | Behavioral Health & Social Service Providers |
N | 103TC0700X |
Psychologist Specialization: Clinical |
0810003490 | VA | Behavioral Health & Social Service Providers |
N | 103TC0700X |
Psychologist Specialization: Clinical |
0810002990 | VA | Behavioral Health & Social Service Providers |
N | 103TC0700X |
Psychologist Specialization: Clinical |
0810003772 | VA | Behavioral Health & Social Service Providers |
N | 103TC0700X |
Psychologist Specialization: Clinical |
0810002885 | VA | Behavioral Health & Social Service Providers |
N | 1041C0700X |
Social Worker Specialization: Clinical |
0904002144 | VA | Behavioral Health & Social Service Providers |
N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
0810003557 | VA | Behavioral Health & Social Service Providers |
N | 1041C0700X |
Social Worker Specialization: Clinical |
0904002754 | VA | Behavioral Health & Social Service Providers |
N | 1041C0700X |
Social Worker Specialization: Clinical |
0904004294 | VA | Behavioral Health & Social Service Providers |
N | 1041C0700X |
Social Worker Specialization: Clinical |
0904006034 | VA | Behavioral Health & Social Service Providers |
N | 235Z00000X | Speech-Language Pathologist | 2202003015 | VA | Speech, Language and Hearing Service Providers |
Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
0810001681 | VA | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
VA | MEDICARE GROUP NUMBER | G00452 | 01 |
Street Address |
3959 PENDER DR SUITE 320 |
City | FAIRFAX |
State | VA |
Zip Code | 22030-6041 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588610679 | Meier Clinics Foundation | Social Worker | 3959 Pender Dr, Suite 305, Fairfax, VA 22030-6041 | 2006-05-26 |
1669860706 | Anne Knabel | Counselor | 3959 Pender Dr, Suite 305, Fairfax, VA 22030-6041 | 2014-12-23 |
1790071694 | Samuel Huisok Yun | Ophthalmology | 3959 Pender Dr, Ste 260, Fairfax, VA 22030-6041 | 2011-06-20 |
1053601450 | Learning Alliance, LLC | Community/Behavioral Health | 3959 Pender Dr, Fairfax, VA 22030-6041 | 2011-04-19 |
1922322106 | Jennifer Wright | Social Worker | 3959 Pender Dr, Ste. 109, Fairfax, VA 22030-6041 | 2010-03-17 |
1992900799 | Sarah Elizabeth Hardy | Psychologist | 3959 Pender Dr, Suite 320, Fairfax, VA 22030-6041 | 2007-06-20 |
1972704575 | Karen N Wires | Speech-Language Pathologist | 3959 Pender Dr, Suite 320, Fairfax, VA 22030-6041 | 2007-05-30 |
1811109663 | Laura Denham Robbins | Social Worker | 3959 Pender Dr, Suite 320, Fairfax, VA 22030-6041 | 2007-05-04 |
1831301084 | Maureen Gallagher | Social Worker | 3959 Pender Dr, Suite 320, Fairfax, VA 22030-6041 | 2007-05-03 |
1518187426 | Patricia Michelle Mullaley | Psychologist | 3959 Pender Dr, #320, Fairfax, VA 22030-6041 | 2007-04-26 |
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1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
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Taxonomy Code | 103TC2200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical Child & Adolescent |
Definition to come... |
Notes: [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457644585 | Tara Banks Wallace | Psychologist | 8626 Lee Hwy Ste 200, Fairfax, VA 22031-2135 | 2011-05-23 |
1093877300 | Susie Elizabeth Caron | Psychologist | 325 Swamp Rd, Fairfax, VT 05454-9777 | 2006-12-14 |
1770656035 | Childhelp,inc. | Psychologist | 11230 Waples Mill Rd Ste 105, Fairfax, VA 22030-6002 | 2006-11-16 |
1245685783 | Michelle Hendrickson | Psychologist | 11204 Waples Mill Rd, Fairfax, VA 22030-6036 | 2016-05-03 |
1285970087 | Catherine A Rathman | Psychologist | 11204 Waples Mill Rd, Fairfax, VA 22030-6036 | 2012-12-26 |
1407052905 | Deborah Cohen | Psychologist | 10339a Democracy Lane, Fairfax, VA 22030 | 2007-06-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083161368 | Nancy Watt Marin | Psychologist | 5060 37th St N, Arlington, VA 22207-1823 | 2016-09-05 |
1407221716 | Spectrum Psychological and Neurotherapy PC | Psychologist | 4542 Bonney Rd Ste B, Virginia Beach, VA 23462 | 2015-12-11 |
1346613668 | Brian Edward Razzino | Psychologist | 150 Little Falls St Ste 200, Falls Church, VA 22046-4315 | 2015-11-09 |
1538597448 | Jadig Garcia | Psychologist | 10571 Telegraph Rd Ste 110, Glen Allen, VA 23059-4652 | 2013-10-31 |
1629327226 | Angela Michelle Malo | Psychologist | 11480 Sunset Hills Rd, Reston, VA 20190-5265 | 2012-08-29 |
1093092272 | Peter F Cooper | Psychologist | 359 Sherwood Ave, Staunton, VA 24401-4430 | 2011-11-15 |
1972889871 | Sara Markese Phd Pllc | Psychologist | 2813 Lee Oaks Ct, Suite 304, Falls Church, VA 22046-7336 | 2011-10-24 |
1598088502 | Megan F Gerbracht | Psychologist | 1489 Chain Bridge Rd Ste 203, Mc Lean, VA 22101-5724 | 2010-03-04 |
1346572351 | Jill Allison Ferrante Gasper | Psychologist | 508 Libbie Ave, Suite 100, Richmond, VA 23226-2618 | 2010-02-02 |
1770754285 | Victor M. Huertas | Psychologist | 8232 La Faye Ct, Alexandria, VA 22306-3200 | 2008-03-13 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.