NPIMap

Organization Active NPI

Soulstice Clinical Counseling & Professional Development

  • Clinical Social Worker
  • Stafford, VA
National Provider Identifier
1235788779
Registry record updated Sep 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SOULSTICE CLINICAL COUNSELING & PROFESSIONAL DEVELOPMENT
Practice address
300 Garrisonville Rd Ste 302
Stafford, VA 22554-8903
Phone
(540) 300-1196
NPI assigned
Sep 7, 2019
Last updated
Sep 7, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2019

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

Authorized official

Name
Phyllis BurginNPI 1295395994
Title
Director
Phone
(540) 300-2096

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

300 Garrisonville Rd Ste 302
Stafford, VA 22554-8903

Mailing address

300 Garrisonville Rd Ste 302
Stafford, VA 22554-8903

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL EHR Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

300 Garrisonville Rd
Ste 302
Stafford, VA 22554
Phone (540) 300-1189

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1567814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567814400000",
    "number": "1235788779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GARRISONVILLE RD STE 302",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225548903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GARRISONVILLE RD STE 302",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225548903",
            "telephone_number": "540-300-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOULSTICE CLINICAL COUNSELING & PROFESSIONAL DEVELOPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-07",
        "last_updated": "2019-09-07",
        "status": "A",
        "authorized_official_last_name": "BURGIN",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "540-300-2096"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "endpointDescription": "Secure Electronic decvice",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "300 Garrisonville Rd Ste 302",
            "city": "Stafford",
            "state": "VA",
            "country_code": "US",
            "postal_code": "225548903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2019; 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.