Prismatic Therapy LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PRISMATIC THERAPY LLC

Practice address

4533 Raleigh Ave
Alexandria, VA 22304-6972

Phone

(703) 249-9523

NPI assigned

Jul 28, 2021

Organization subpart

No

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

Authorized official

Name

Megan Green, LPCNPI 1558037457

Title

Owner and Professional Counselor

Phone

(703) 249-9523

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Megan Patience Green, LPC

  • Professional Counselor
  • Alexandria, VA
  • NPI 1558037457
  NPD Authorized official

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1508539370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 BELLE VIEW BLVD # 4120",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223076531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4533 RALEIGH AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223046972",
            "telephone_number": "703-249-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISMATIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "OWNER AND PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "703-249-9523",
        "authorized_official_credential": "LPC"
    },
    "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": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; 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.