Safe and Stable Families Wellness Center, P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701006356 Issued in VA

Legal business name

SAFE AND STABLE FAMILIES WELLNESS CENTER, P.C.

Practice address

7825 Midlothian Tpke Ste 203
North Chesterfield, VA 23235-5247

Phone

(229) 412-8125

NPI assigned

Apr 3, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Agustin J Cruz, LPCNPI 1982004503

Title

Chief Executive Officer

Phone

(229) 412-8125

Specialties & licenses 7

Addresses

Other identifiers 1

Locations

Practitioners 3

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

• Agustin Joseph Cruz, MPA, MS, LPC

  • Professional Counselor
  • North Chesterfield, VA
  • NPI 1982004503
  NPD Authorized official
• Angelo Luis Cabrera, LPC

  • Counselor
  • North Chesterfield, VA
  • NPI 1548764582
  NPD (past)
• Sylvia L Pegram

  • Counselor
  • North Chesterfield, VA
  • NPI 1952815698
  NPD (past)

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491177600000",
    "number": "1124550587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7825 MIDLOTHIAN TPKE STE 203",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232355247",
            "telephone_number": "229-412-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7825 MIDLOTHIAN TPKE STE 203",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232355247",
            "telephone_number": "229-412-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE AND STABLE FAMILIES WELLNESS CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-03",
        "last_updated": "2017-04-03",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "AGUSTIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "229-412-8125",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "VA",
            "license": "0701006356",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0701006356",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701006356",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701006356",
            "primary": true
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychoanalyst",
            "state": "VA",
            "license": "0701006356",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0701006356",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717001358",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "601092813",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; 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.