NPIMap

Organization Active NPI

Prince William County Early Intervention Program

  • Rehabilitation Clinic/Center
  • Manassas, VA
National Provider Identifier
1184823155
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
PRINCE WILLIAM COUNTY EARLY INTERVENTION PROGRAM
Practice address
7969 Ashton Ave
Manassas, VA 20109-2885
Phone
(703) 792-7800
Fax
(703) 792-5699
NPI assigned
Jul 11, 2007
Organization subpart
Yes
Parent organization
PRINCE WILLIAM COUNTY COMMUNITY SERVICES BOARDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Authorized official

Name
Lisa Madron
Title
Executive Director
Phone
(703) 792-7800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

7969 Ashton Ave
Manassas, VA 20109-2885

Mailing address

7969 Ashton Ave
Manassas, VA 20109-2885
Phone (703) 792-7800

Other identifiers 4

IdentifierTypeStateIssuer
187840OtherVAANTHEM BLUE CROSS BLUE SH
187835OtherVAANTHEM BLUE CROSS BLUE SH
187839OtherVAANTHEM BLUE CROSS BLUE SH
004978277MedicaidVA

National Provider Directory

National Provider Directory
Tax ID family
Prince William County G7 organizations share this tax ID, including this one
Part of
Prince William County G

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7987 Ashton Ave
Ste 231
Manassas, VA 20109

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744329600000",
    "number": "1184823155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7969 ASHTON AVE",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092885",
            "telephone_number": "703-792-7800",
            "fax_number": "703-792-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7969 ASHTON AVE",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092885",
            "telephone_number": "703-792-7800",
            "fax_number": "703-792-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCE WILLIAM COUNTY EARLY INTERVENTION PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRINCE WILLIAM COUNTY COMMUNITY SERVICES BOARD",
        "enumeration_date": "2007-07-11",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A",
        "authorized_official_last_name": "MADRON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "703-792-7800"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "187840",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "187835",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "187839",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004978277",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.