Organization Active NPI

Faith and Trust Psychiatric Living

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Vienna, VA
National Provider Identifier
1447130679
Registry record updated Nov 2, 2025
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
FAITH AND TRUST PSYCHIATRIC LIVING
Practice address
1964 Gallows Rd Ste 310
Vienna, VA 22182-3814
Phone
(571) 762-9099
NPI assigned
Sep 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2025

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

Authorized official

Name
Mrs. Eveline Fohtung, NPNPI 1649004979
Title
Owner
Phone
(571) 762-9099

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

1964 Gallows Rd Ste 310
Vienna, VA 22182-3814

Mailing address

1964 Gallows Rd Ste 310
Vienna, VA 22182-3814
Phone (571) 762-9099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251111000936 VA Part B Supplier - Clinic/Group Practice 5193216885 Receives reassigned benefits from 1 practitioner
Practice locations: Fredericksburg, VA

National Provider Directory

National Provider Directory

Locations

11 Smokehouse Dr
Fredericksburg, VA 22406
Phone (571) 762-9099

1964 Gallows Rd
Ste 310
Vienna, VA 22182
Phone (571) 762-9099

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": "1757289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762041600000",
    "number": "1447130679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1964 GALLOWS RD STE 310",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823814",
            "telephone_number": "571-762-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1964 GALLOWS RD STE 310",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823814",
            "telephone_number": "571-762-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH AND TRUST PSYCHIATRIC LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-11-02",
        "certification_date": "2025-11-02",
        "status": "A",
        "authorized_official_last_name": "FOHTUNG",
        "authorized_official_first_name": "EVELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-762-9099",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.