NPIMap

Organization Active NPI

Mind Perception Therapy

  • Professional Counselor
  • Woodbridge, VA
National Provider Identifier
1649886151
Registry record updated Sep 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MIND PERCEPTION THERAPY
Practice address
4736 Grand Masters Way
Woodbridge, VA 22192-5553
Phone
(979) 574-9568
NPI assigned
Sep 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2020

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

Authorized official

Name
Mrs. Misty Melissa Brady-Lee, LPCNPI 1992234298
Title
Owner
Phone
(979) 574-9568

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
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

4736 Grand Masters Way
Woodbridge, VA 22192-5553

Mailing address

4736 Grand Masters Way
Woodbridge, VA 22192-5553
Phone (979) 574-9568

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1600560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600560000000",
    "number": "1649886151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4736 GRAND MASTERS WAY",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925553",
            "telephone_number": "979-574-9568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4736 GRAND MASTERS WAY",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925553",
            "telephone_number": "979-574-9568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND PERCEPTION THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-20",
        "last_updated": "2020-09-20",
        "certification_date": "2020-09-20",
        "status": "A",
        "authorized_official_last_name": "BRADY-LEE",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-574-9568",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2020; 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.