Pro-Therapy, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PRO-THERAPY, LLC

Practice address

3316 Longstreet Dr
Petersburg, VA 23805-2641

Phone

(804) 721-3306

NPI assigned

May 23, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Tanikka L Mason, LCSWNPI 1659731131

Title

Chief Clinical Officer

Phone

(804) 721-3306

Specialties & licenses 1

Addresses

Practitioners 1

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

• Tanikka Mason, LCSW

  • Clinical Social Worker
  • Petersburg, VA
  • NPI 1659731131
  NPD Authorized official

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1144069667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3405",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230583405",
            "telephone_number": "804-721-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 LONGSTREET DR",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238052641",
            "telephone_number": "804-721-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "TANIKKA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "804-721-3306",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Petersburg, VA
• Providers in Petersburg, 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 May 23, 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.