Active NPI
Ellen Brigham, ATR-BC
- Art Therapist
- Fairfax, VA
National Provider Identifier
1326522871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Art Therapist
- License
- 18-076
- Practice address
- 11230 Waples Mill Rd Ste 100
Fairfax, VA 22030-6087 - Phone
- (703) 309-4363
- NPI assigned
- Sep 20, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Art Therapist | 221700000X | 18-076 | VA | Primary |
Addresses
Primary practice location
11230 Waples Mill Rd Ste 100
Fairfax, VA 22030-6087
Mailing address
14464 Glencrest Cir
Centreville, VA 20120-4131
Phone (703) 309-4363
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18-076 | VA | MD | Art Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537401600000",
"number": "1326522871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14464 GLENCREST CIR",
"city": "CENTREVILLE",
"state": "VA",
"postal_code": "201204131",
"telephone_number": "703-309-4363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11230 WAPLES MILL RD STE 100",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220306087",
"telephone_number": "703-309-4363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIGHAM",
"first_name": "ELLEN",
"credential": "ATR-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-20",
"last_updated": "2018-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": "VA",
"license": "18-076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.