Leesburg Community Church

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701001459 Issued in VA

Legal business name

LEESBURG COMMUNITY CHURCH

Practice address

815 Lee Ave SW Ste B
Leesburg, VA 20175-3416

Phone

(703) 777-2209

NPI assigned

Mar 29, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Timothy J Teague, PH.D.

Title

Director

Phone

(703) 777-2209

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301356800000",
    "number": "1013206200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 LEE AVE SW",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201753416",
            "telephone_number": "703-777-2209",
            "fax_number": "703-779-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 LEE AVE SW STE B",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201753416",
            "telephone_number": "703-777-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEESBURG COMMUNITY CHURCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-29",
        "last_updated": "2011-03-29",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "703-777-2209",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701001459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Leesburg, VA
• Providers in Leesburg, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.