Potomac Psychological Center, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701003403 Issued in VA

Legal business name

POTOMAC PSYCHOLOGICAL CENTER, LLC

Practice address

20925 Professional PLZ
Suite 230
Ashburn, VA 20147-3403

Phone

(703) 858-7838

Fax

(703) 858-9697

NPI assigned

Jul 7, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Nick Gentile, LPC

Title

President

Phone

(703) 858-7838

Specialties & licenses 5

Addresses

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246924800000",
    "number": "1497984892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20925 PROFESSIONAL PLZ",
            "address_2": "SUITE 230",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201473403",
            "telephone_number": "703-858-7838",
            "fax_number": "703-858-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20925 PROFESSIONAL PLZ",
            "address_2": "SUITE 230",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201473403",
            "telephone_number": "703-858-7838",
            "fax_number": "703-858-9697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC PSYCHOLOGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-07",
        "last_updated": "2009-07-07",
        "status": "A",
        "authorized_official_last_name": "GENTILE",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-858-7838",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701003403",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003656",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904004863",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101231051",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101241532",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Rose Poole, LMT
• Sarah Elizabeth Porco, RN (COMPACT LICENSE)
• Ashley Porter, MASSAGE THERAPIST
• Nicolas Pablo Posa, PT, DPT
• Potomac Medical Equipment
• Neha Potphode, BEHAVIOR TECHNICIAN
• Katie Elizabeth Pounder
• Tracey Dove Powell, MS, LPC
• Annie Pratt, PA-C
• Premier Dermatology, P.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2009; 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.