Individual provider Active NPI

Christopher Neal Mishik, LPC

  • Professional Counselor
  • Annandale, VA
National Provider Identifier
1629794805
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701011121 Issued in VA
Practice address
7630 Little River Tpke Ste 601
Annandale, VA 22003-2600
Phone
(833) 698-4357
NPI assigned
Oct 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701011121 VA Primary

Addresses

Primary practice location

7630 Little River Tpke Ste 601
Annandale, VA 22003-2600

Mailing address

12617 Rock Ridge Rd
Herndon, VA 20170-2878
Phone (202) 860-7565

Other practice location 1

12617 Rock Ridge Rd
Herndon, VA 20170-2878
Phone (202) 860-7565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0701011121VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Envision Counseling, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1629794805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12617 ROCK RIDGE RD",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201702878",
            "telephone_number": "202-860-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7630 LITTLE RIVER TPKE STE 601",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032600",
            "telephone_number": "833-698-4357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12617 Rock Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Herndon",
            "state": "VA",
            "postal_code": "201702878",
            "country_code": "US",
            "telephone_number": "202-860-7565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISHIK",
        "first_name": "CHRISTOPHER",
        "middle_name": "NEAL",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701011121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.