Individual provider Active NPI

Mariam Mohsen, LMFT-R

  • Marriage & Family Therapist
  • Virginia Beach, VA
National Provider Identifier
1356050389
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
0730000670 Issued in VA
Practice address
5301 Providence Rd Ste 20
Virginia Beach, VA 23464-4128
Phone
(757) 347-8840
NPI assigned
Nov 17, 2022
Last updated
Nov 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0730000670 VA Primary

Addresses

Primary practice location

5301 Providence Rd Ste 20
Virginia Beach, VA 23464-4128

Mailing address

5301 Providence Rd Ste 20
Virginia Beach, VA 23464-4128

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

LicenseStateTypeSpecialty
0730000670VAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa Duez LCSW LLC CurrentSince Nov 20, 2022 Accepting new patients

Locations

5301 Providence Rd
Ste 20
Virginia Beach, VA 23464
Phone (757) 347-8840

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1356050389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 PROVIDENCE RD STE 20",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 PROVIDENCE RD STE 20",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644128",
            "telephone_number": "757-347-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHSEN",
        "first_name": "MARIAM",
        "credential": "LMFT-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0730000670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.