NPIMap

Organization Active NPI

Prosperity Eating Disorder and Wellness

  • Adolescent and Children Mental Health Clinic/Center
  • Reston, VA
National Provider Identifier
1043613474
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
PROSPERITY EATING DISORDER AND WELLNESS
Practice address
1897 Preston White Dr Ste 300
Reston, VA 20191-5479
Phone
(703) 466-5150
Fax
(703) 649-3599
NPI assigned
Sep 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Authorized official

Name
Heather Nelson Baker, LCSW
Title
Ceo
Phone
(703) 466-5150

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

1897 Preston White Dr Ste 300
Reston, VA 20191-5479

Mailing address

1897 Preston White Dr Ste 300
Reston, VA 20191-5479
Phone (703) 466-5150

National Provider Directory

National Provider Directory
Tax ID family
Prosperity Eating Disorder and Wellness4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1031 Sterling Rd
Ste 203
Herndon, VA 20170
Phone (703) 446-5150

1897 Preston White Dr
Ste 300
Reston, VA 20191
Phone (703) 466-5150

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750118400000",
    "number": "1043613474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1897 PRESTON WHITE DR STE 300",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201915479",
            "telephone_number": "703-466-5150",
            "fax_number": "703-649-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1897 PRESTON WHITE DR STE 300",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201915479",
            "telephone_number": "703-466-5150",
            "fax_number": "703-649-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPERITY EATING DISORDER AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-30",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "NELSON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "703-466-5150",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.