Divorce and Marital Stress Clinic Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904000834 Issued in VA

Legal business name

DIVORCE AND MARITAL STRESS CLINIC INC

Doing business as

Key Bridge Therapy and Mediation Center

Practice address

1600 Wilson Blvd
Suite 702
Arlington, VA 22209-2505

Phone

(703) 528-3900

Fax

(703) 524-7525

NPI assigned

Mar 26, 2007

Last updated

Aug 22, 2020By 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

Emily M Brown, LCSW MSW

Title

Director

Phone

(703) 528-3900

Specialties & licenses 1

Addresses

Other names 1

• Key Bridge Therapy and Mediation Center Doing business as

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407974843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 WILSON BLVD",
            "address_2": "SUITE 702",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222092505",
            "telephone_number": "703-528-3900",
            "fax_number": "703-524-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 WILSON BLVD",
            "address_2": "SUITE 702",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222092505",
            "telephone_number": "703-528-3900",
            "fax_number": "703-524-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVORCE AND MARITAL STRESS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "703-528-3900",
        "authorized_official_credential": "LCSW MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904000834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Key Bridge Therapy and Mediation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kendall Discenza, MS, RD
• Drew Adam Dismuke, B.C.A.B.A.
• District Sports & Rehab
• District Wellness LLC
• Michelle C Divito, MD
• Sarah Bowen Dix, LCSW
• Alison DO
• To-Uyen Thi DO, PHARMD
• Nini Doan, PHARMD
• Phuoc Kim Doan, M.D.

• Clinical Social Worker in Arlington, VA
• Providers in Arlington, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.