Vip Therapy & Wellness Services

Primary specialty

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

Legal business name

VIP THERAPY & WELLNESS SERVICES

Practice address

137 National PLZ Ste 300
Oxon Hill, MD 20745-1153

Phone

(951) 977-1388

NPI assigned

Jan 3, 2024

Organization subpart

No

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

Authorized official

Name

Kelly JacksonNPI 1710435953

Title

Ceo

Phone

(951) 977-1388

Specialties & licenses 3

Addresses

Locations

Practitioners 1

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

• Kelly Jackson, LCSW-C

  • Clinical Social Worker
  • National Harbor, MD
  • NPI 1710435953
  NPD Authorized official

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1306616024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 DUNNINGTON PL",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220262871",
            "telephone_number": "301-395-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 NATIONAL PLZ STE 300",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207451153",
            "telephone_number": "951-977-1388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIP THERAPY & WELLNESS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-977-1388"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanguard Home Care, LLC
• Delin George Varghese, PT, DPT
• Marie Ruth Viassy
• Vishal Mahendra Vijapurkar
• Vincent J Zugay DDS PA
• Shirley Wakefield
• Lewahn Wallace
• Mary Elizabeth Wallace, DNP, CRNP, A-GNP-C
• Stephane Wantou Siantou, PHARMD
• Indya Warr

• Mental Health Clinic/Center (Including Community Mental Health Center) in Oxon Hill, MD
• Providers in Oxon Hill, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.