Imend Therapy LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

IMEND THERAPY LLC

Practice address

9020 Lorton Station Blvd Ste 116
Lorton, VA 22079-4750

Phone

(571) 470-3266

NPI assigned

Mar 6, 2023

Last updated

Mar 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Sharon Fernandez, LPC, NCCNPI 1124756010

Title

Director/President

Phone

(571) 470-3266

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sharon Fernandez

  • Professional Counselor
  • Woodbridge, VA
  • NPI 1124756010
  NPD Authorized official
• Noelle Cook

  • Mental Health Counselor
  • Lorton, VA
  • NPI 1699646513
  NPD

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1396445615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8362 MIDDLE RUDDINGS DR",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220795023",
            "telephone_number": "703-568-5647",
            "fax_number": "703-493-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9020 LORTON STATION BLVD STE 116",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220794750",
            "telephone_number": "571-470-3266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMEND THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "DIRECTOR/PRESIDENT",
        "authorized_official_telephone_number": "571-470-3266",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1124756010",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Lorton, VA
• Providers in Lorton, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.