Custom Addiction Recovery Anonymous, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CUSTOM ADDICTION RECOVERY ANONYMOUS, LLC

Practice address

6951 Duncraig Court
McLean, VA 22101

Phone

(571) 499-0626

NPI assigned

Aug 22, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Laura D Simon-Sulzer, MA; CSAC, COACH

Title

Ceo

Phone

(571) 499-0626

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408665600000",
    "number": "1659770923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6951 DUNCRAIG COURT",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "22101",
            "telephone_number": "571-499-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6951 DUNCRAIG COURT",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "22101",
            "telephone_number": "571-499-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM ADDICTION RECOVERY ANONYMOUS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-22",
        "last_updated": "2014-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMON-SULZER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "571-499-0626",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA; CSAC, COACH"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in McLean, VA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; 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.