Cornita Mental Health Services, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024165883 Issued in VA

Legal business name

CORNITA MENTAL HEALTH SERVICES, LLC

Practice address

1800 Town Center Dr Ste 420
Reston, VA 20190-3240

Phone

(703) 869-5361

Fax

(703) 957-3625

NPI assigned

Oct 28, 2014

Organization subpart

No

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

Authorized official

Name

Cordelia Nieketien-Tawari, DNP, APRN-BC, LNP

Title

Ceo/Psych NP Probider

Phone

(703) 869-5361

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• Cordelia Nieketien-Tawari Doing business as

Locations

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711324800000",
    "number": "1134524580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2692",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201950692",
            "telephone_number": "703-869-5361",
            "fax_number": "703-957-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 TOWN CENTER DR STE 420",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903240",
            "telephone_number": "703-869-5361",
            "fax_number": "703-957-3625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNITA MENTAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-28",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A",
        "authorized_official_last_name": "NIEKETIEN-TAWARI",
        "authorized_official_first_name": "CORDELIA",
        "authorized_official_title_or_position": "CEO/PSYCH NP PROBIDER",
        "authorized_official_telephone_number": "703-869-5361",
        "authorized_official_credential": "DNP, APRN-BC, LNP"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0017137987",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024165883",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024165883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI (2)",
            "identifier": "1134524580",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NO.",
            "identifier": "11946976",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI (1)",
            "identifier": "1194827139",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA STATE  BOARD OF NURSING-NP LICENSE",
            "identifier": "0024165883",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cordelia Nieketien-Tawari",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Corbet
• Anju Bhargava Corbishdale, PH.D.
• Eleanor Corcoran, RNFA
• Lauren Cormier
• Eboni Nicole Cornish, M.D.
• Bruce V Corsino, PSY. D.
• Stephanie U Cortez, MSN, FNP-C
• Jessica Mary Cortezzo, CRNA
• Shane Ryan Costa, D.D.S
• Catherine Coughlin, M.A. BCBA

• Psychiatric/Mental Health Nurse Practitioner in Reston, VA
• Providers in Reston, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.