NPIMap

Organization Active NPI

Pimmit Counseling & Wellness Clinic PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Vienna, VA
National Provider Identifier
1407346695
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
PIMMIT COUNSELING & WELLNESS CLINIC PLLC
Practice address
2235 Cedar LN Ste 102
Vienna, VA 22182-5247
Phone
(703) 556-4888
NPI assigned
May 14, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Authorized official

Name
Dr. Shahrzad N/a Poorshaghaghi, ED.DNPI 1437171337
Title
Director
Phone
(703) 556-4888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

2235 Cedar LN Ste 102
Vienna, VA 22182-5247

Mailing address

2235 Cedar LN Ste 102
Vienna, VA 22182-5247
Phone (703) 556-4888

Other identifiers 1

IdentifierTypeStateIssuer
5411165MedicaidVA

Other names 1

  • Pimmit Counseling & Wellness Clinic ABA Program Other name

National Provider Directory

National Provider Directory
Tax ID family
Pimmit Counseling Wellness Clinic ABA Program2 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.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601856000000",
    "number": "1407346695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 CEDAR LN STE 102",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221825247",
            "telephone_number": "703-556-4888",
            "fax_number": "703-556-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 CEDAR LN STE 102",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221825247",
            "telephone_number": "703-556-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIMMIT COUNSELING & WELLNESS CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-14",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A",
        "authorized_official_last_name": "POORSHAGHAGHI",
        "authorized_official_first_name": "SHAHRZAD",
        "authorized_official_middle_name": "N/A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "703-556-4888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5411165",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pimmit Counseling & Wellness Clinic ABA Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.