Resilient Therapy LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

RESILIENT THERAPY LLC

Practice address

4932 Dominion Blvd
Glen Allen, VA 23060-6714

Phone

(804) 592-1097

Fax

(804) 592-1097

NPI assigned

Mar 20, 2024

Organization subpart

No

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

Authorized official

Name

Michael Ingram, LPCNPI 1790086262

Title

Owner

Phone

(804) 592-1097

Specialties & licenses 1

Addresses

Practitioners 1

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

• Michael Joseph Ingram, LPC

  • Professional Counselor
  • Richmond, VA
  • NPI 1790086262
  NPD Authorized official

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1336909167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4932 DOMINION BLVD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230606714",
            "telephone_number": "804-592-1097",
            "fax_number": "804-592-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4932 DOMINION BLVD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230606714",
            "telephone_number": "804-592-1097",
            "fax_number": "804-592-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENT THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-20",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-592-1097",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.