Restore Counseling, LLC

Primary specialty

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

License

0701007802 Issued in VA

Legal business name

RESTORE COUNSELING, LLC

Practice address

10301 Democracy LN Ste 275
Fairfax, VA 22030-2525

Phone

(845) 321-0430

NPI assigned

Aug 10, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Elizabeth Joy Rzengota, M.A., LPC

Title

Owner

Phone

(703) 397-3124

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537574400000",
    "number": "1295214112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10301 DEMOCRACY LN STE 275",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302525",
            "telephone_number": "703-397-3124",
            "fax_number": "703-539-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 DEMOCRACY LN STE 275",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302525",
            "telephone_number": "845-321-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-10",
        "last_updated": "2018-09-22",
        "status": "A",
        "authorized_official_last_name": "RZENGOTA",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-397-3124",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.A., LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "VA",
            "license": "0701007802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Sep 22, 2018; 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.