NPIMap

Organization Active NPI

Pearl Vitality Counseling

  • Community/Behavioral Health Agency
  • Alexandria, VA
National Provider Identifier
1639687312
Registry record updated Jan 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
0904008852 Issued in VA
Legal business name
PEARL VITALITY COUNSELING
Practice address
4809 Eisenhower Ave Ste B
Alexandria, VA 22304-4832
Phone
(757) 358-1771
NPI assigned
Jan 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2018

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

Authorized official

Name
Talia Bryan, LCSWNPI 1801243019
Title
Therapist/ LCSW
Phone
(757) 358-1771

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 0904008852 VA Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X 0904008852 VA
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

4809 Eisenhower Ave Ste B
Alexandria, VA 22304-4832

Mailing address

650 Potomac Ave Apt 410
Alexandria, VA 22301-3072
Phone (757) 358-1771

National Provider Directory

National Provider Directory

Locations

4809 Eisenhower Ave
#B
Alexandria, VA 22304
Phone (757) 358-1771

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516147200000",
    "number": "1639687312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 POTOMAC AVE APT 410",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223013072",
            "telephone_number": "757-358-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4809 EISENHOWER AVE STE B",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223044832",
            "telephone_number": "757-358-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL VITALITY COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-17",
        "last_updated": "2018-01-17",
        "status": "A",
        "authorized_official_last_name": "BRYAN",
        "authorized_official_first_name": "TALIA",
        "authorized_official_title_or_position": "THERAPIST/ LCSW",
        "authorized_official_telephone_number": "757-358-1771",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "0904008852",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "VA",
            "license": "0904008852",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2018; 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.