Old Town Psychotherapy

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

OLD TOWN PSYCHOTHERAPY

Practice address

218 N Lee St Ste 201
Alexandria, VA 22314-2631

Phone

(831) 236-5801

Fax

(703) 842-8135

NPI assigned

Mar 31, 2021

Organization subpart

No

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

Authorized official

Name

Christina Madsen Fishback, LCSWNPI 1821576547

Title

Psychotherapist

Phone

(831) 236-5801

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Christina Madsen Fishback, LCSW

  • Social Worker
  • Alexandria, VA
  • NPI 1821576547
  NPD Authorized official

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617148800000",
    "number": "1043898935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 N LEE ST STE 201",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142631",
            "telephone_number": "831-236-5801",
            "fax_number": "703-842-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 N LEE ST STE 201",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142631",
            "telephone_number": "831-236-5801",
            "fax_number": "703-842-8135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TOWN PSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A",
        "authorized_official_last_name": "FISHBACK",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "MADSEN",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "831-236-5801",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Old Town Alexandria Chiropractic LLC
• Old Town Dental Partners
• Old Town Dental Partners, PC
• Old Town Professional Psychology
• Old Town Psychology
• Old Town Therapy & Wellness Center, LLC
• Old Towne Chiropractic Services LTD
• Olde Towne Obstetrics & Gynecology, LLC
• Andrea Olguin
• Sophia Susana Olguin

• Community/Behavioral Health Agency in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.