Prince Wiliam Family Counseling, PC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0904002397 Issued in VA

Legal business name

PRINCE WILIAM FAMILY COUNSELING, PC

Practice address

9625 Surveyor CT
Suite 200
Manassas, VA 20110-4422

Phone

(703) 330-9933

Fax

(703) 368-8454

NPI assigned

Dec 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Henry Koch, PSYCHOLOGISTNPI 1487679585

Title

Director

Phone

(703) 330-9933

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Prince Wiliam Family Counseling PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Prince William Family Counseling, P.C.

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Manassas, VA
  • NPI 1316024425
  NPD tax ID

Practitioners 1

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

• Henry Thomas Koch III, PH.D.

  • Mental Health Counselor
  • Manassas, VA
  • NPI 1487679585
  NPD (past) Authorized official

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326102799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9625 SURVEYOR CT",
            "address_2": "SUITE 200",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104422",
            "telephone_number": "703-330-9933",
            "fax_number": "703-368-8454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9625 SURVEYOR CT",
            "address_2": "SUITE 200",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104422",
            "telephone_number": "703-330-9933",
            "fax_number": "703-368-8454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCE WILIAM FAMILY COUNSELING, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "703-330-9933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYCHOLOGIST"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0904002397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5411637",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Marie Price, BCBA, LBA
• Victoria Stames Price, MA
• Primary Care Medicine LLC
• Janine Prime, NP
• Primedoc of Manassas PC
• Prince William Ambulatory Surgery Center, LLC
• Prince William Cardiology Associates
• Prince William Community Services
• Prince William County Community Services Board
• Prince William County Community Services Board

• Mental Health Counselor in Manassas, VA
• Providers in Manassas, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.