Ephesians Life Ministries

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0904005471 Issued in VA

Legal business name

EPHESIANS LIFE MINISTRIES

Practice address

260 Cedar LN SE # B
Vienna, VA 22180-6698

Phone

(703) 204-0250

NPI assigned

Jan 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Sunny S Park, L.C.S.W.-C

Title

Therapist

Phone

(240) 472-3216

Specialties & licenses 2

Addresses

Other identifiers 5

Tax ID family

Ephesians Life Ministries3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Ephesians Life Ministries

  • Clinical Social Worker
  • Silver Spring, MD
  • NPI 1831420991
  NPD tax ID
• Type 1 Individual Provider

  • Exclusive Provider Organization
  • Silver Spring, MD
  • NPI 1952543191
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Valerie Schnibbe Smith, MSW

  • Social Worker
  • Annandale, VA
  • NPI 1215095450
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003967563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 ELTON RD STE 204",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209031760",
            "telephone_number": "301-439-7191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 CEDAR LN SE # B",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221806698",
            "telephone_number": "703-204-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPHESIANS LIFE MINISTRIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "SUNNY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "240-472-3216",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "L.C.S.W.-C"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "11220",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0904005471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7839381",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "258321",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "2133171",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "351252",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "633647",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Vienna, VA
• Providers in Vienna, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.