Positive Mind, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0101255740 Issued in VA

Legal business name

POSITIVE MIND, LLC

Practice address

6181 Windham Hill Run
Alexandria, VA 22315-3726

Phone

(703) 623-5150

Fax

(301) 808-0282

NPI assigned

Apr 19, 2016

Organization subpart

No

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

Authorized official

Name

Rajeev Sharma, MD

Title

Owner

Phone

(703) 623-5150

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461024000000",
    "number": "1508210253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6181 WINDHAM HILL RUN",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223153726",
            "telephone_number": "703-623-5150",
            "fax_number": "301-808-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6181 WINDHAM HILL RUN",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223153726",
            "telephone_number": "703-623-5150",
            "fax_number": "301-808-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POSITIVE MIND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-19",
        "last_updated": "2016-04-19",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "RAJEEV",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-623-5150",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0101255740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12663498",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diamond Renee Porter, BT
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• Clinical Psychologist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; 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.