NPIMap

Organization Active NPI

Sage House Art Therapy, PLLC

  • Professional Counselor
  • Reston, VA
National Provider Identifier
1467071142
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
SAGE HOUSE ART THERAPY, PLLC
Practice address
11250 Roger Bacon Dr BLDG 10
Reston, VA 20190-5219
Phone
(703) 483-9442
NPI assigned
Apr 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Authorized official

Name
Kathryn Tedeschi
Title
Clinical Director
Phone
(703) 483-9442

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

11250 Roger Bacon Dr BLDG 10
Reston, VA 20190-5219

Mailing address

11250 Roger Bacon Dr BLDG 10
Reston, VA 20190-5219

Other identifiers 1

IdentifierTypeStateIssuer
0701007801OtherVAVIRGINIA BOARD OF COUNSELING

Other names 1

  • Sage House Counseling & Art Therapy Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Theranest

National Provider Directory

National Provider Directory
Tax ID family
Sage House Art Therapy PLLC2 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.

NPI Registry JSON

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1467071142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11250 ROGER BACON DR BLDG 10",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11250 ROGER BACON DR BLDG 10",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905219",
            "telephone_number": "703-483-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE HOUSE ART THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-13",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "TEDESCHI",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "703-483-9442"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA BOARD OF COUNSELING",
            "identifier": "0701007801",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Theranest",
            "affiliation": "N",
            "address_1": "11250 Roger Bacon Dr Bldg 10",
            "city": "Reston",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201905219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Sage House Counseling & Art Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.