Mental Health Therapy Center - Northern Virginia, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MENTAL HEALTH THERAPY CENTER - NORTHERN VIRGINIA, LLC

Practice address

10721 Main St Ste 1300
Fairfax, VA 22030-6902

Phone

(703) 536-2000

NPI assigned

Jun 4, 2024

Last updated

Jun 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mike Gingras

Title

Division Cfo

Phone

(804) 228-4901

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1194566117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10721 MAIN ST STE 1300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10721 MAIN ST STE 1300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306902",
            "telephone_number": "703-536-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH THERAPY CENTER - NORTHERN VIRGINIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "GINGRAS",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "DIVISION CFO",
        "authorized_official_telephone_number": "804-228-4901"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudia Mendez
• Kevin Jonelle Mendez, DC
• Sonia Mendoza
• Tiffany Ann Pastors Mendoza, FNP
• Mental Health Services En Espanol LLC (Victoria Transcultural Clinical Center LLC)
• Saniya Merchant, MD
• Chinelo Mere, PHARMD
• Diana Meredith
• Jack Merenda, PSYD
• Maria Aryza B Merida, M.A., CCC-SLP

• Mental Health Clinic/Center (Including Community Mental Health Center) in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.