Independence Empowerment Center

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

INDEPENDENCE EMPOWERMENT CENTER

Practice address

8409 Dorsey Cir
Suite # 101-102
Manassas, VA 20110-8305

Phone

(703) 257-5400

Fax

(703) 257-5043

NPI assigned

Oct 14, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Mary D Lopez, PH.D

Title

Executive Director

Phone

(703) 257-5400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444780800000",
    "number": "1083085161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8409 DORSEY CIR",
            "address_2": "SUITE # 101-102",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201108305",
            "telephone_number": "703-257-5400",
            "fax_number": "703-257-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8409 DORSEY CIR",
            "address_2": "SUITE # 101-102",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201108305",
            "telephone_number": "703-257-5400",
            "fax_number": "703-257-5043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE EMPOWERMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-14",
        "last_updated": "2015-10-14",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "703-257-5400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0087405426",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Manassas, VA
• Providers in Manassas, VA by specialty
• Case Management Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; 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.