NPIMap

Organization Active NPI

Renewal of the Mind

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fairfax, VA
National Provider Identifier
1548835705
Registry record updated May 20, 2021
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
RENEWAL OF THE MIND
Practice address
10560 Main St
Fairfax, VA 22030-7182
Phone
(972) 880-3510
NPI assigned
May 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Authorized official

Name
Mrs. Naglaa Moussa, LPCNPI 1023513512
Title
Founder
Phone
(972) 880-3510

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

10560 Main St
Fairfax, VA 22030-7182

Mailing address

13199 Guildtown PL
Bristow, VA 20136-5613
Phone (972) 880-3510

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.vapsychotherpay.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241203002327 DC Part B Supplier - Clinic/Group Practice 2466987235 Receives reassigned benefits from 1 practitioner
Practice locations: Fairfax, VA

National Provider Directory

National Provider Directory

Locations

10560 Main St
Ste 610
Fairfax, VA 22030
Phone (571) 264-8192

10560 Main St
Fairfax, VA 22030
Phone (571) 264-8192

Practitioners & affiliated clinicians

Practitioners 12

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": "1621468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1548835705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13199 GUILDTOWN PL",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201365613",
            "telephone_number": "972-880-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10560 MAIN ST",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307182",
            "telephone_number": "972-880-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWAL OF THE MIND",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "MOUSSA",
        "authorized_official_first_name": "NAGLAA",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "972-880-3510",
        "authorized_official_name_prefix": "Mrs.",
        "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": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.vapsychotherpay.com",
            "affiliation": "N",
            "address_1": "10560 Main St",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220307182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.