NPIMap

Organization Active NPI

Holystick,LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fairfax, VA
National Provider Identifier
1619506300
Registry record updated Jan 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
HOLYSTICK,LLC
Practice address
8550 Route 29 Ste 720
Fairfax, VA 22031-1531
Phone
(703) 981-5085
Fax
(240) 901-4515
NPI assigned
Apr 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2026

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

Authorized official

Name
Hanul Jung, DOANPI 1023399755
Title
Ceo
Phone
(240) 945-8525

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

8550 Route 29 Ste 720
Fairfax, VA 22031-1531

Mailing address

14428 Homecrest Rd
Silver Spring, MD 20906-1820
Phone (240) 506-6549

Other practice location 1

15200 Shady Grove Rd
Rockville, MD 20850-3218
Phone (240) 945-8525

Other names 3

  • Acupuncture Doing business as
  • Medical Facility Doing business as
  • HolyStick,LLC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Acupuncture2 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.

Locations

8550 Route 29
Ste 720
Fairfax, VA 22031
Phone (703) 981-5085

Practitioners & affiliated clinicians

Practitioners 2

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": "1585872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768694400000",
    "number": "1619506300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14428 HOMECREST RD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209061820",
            "telephone_number": "240-506-6549",
            "fax_number": "240-901-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 ROUTE 29 STE 720",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220311531",
            "telephone_number": "703-981-5085",
            "fax_number": "240-901-4515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15200 Shady Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Rockville",
            "state": "MD",
            "postal_code": "208503218",
            "country_code": "US",
            "telephone_number": "240-945-8525",
            "fax_number": "240-901-4515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOLYSTICK,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-03",
        "last_updated": "2026-01-18",
        "certification_date": "2026-01-18",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "HANUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-945-8525",
        "authorized_official_credential": "DOA"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Acupuncture",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medical Facility",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HolyStick,LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jan 18, 2026; 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.