Phoenix Counselinggroup and Play Therapycenter, PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701004422 Issued in VA

Legal business name

PHOENIX COUNSELINGGROUP AND PLAY THERAPYCENTER, PLLC

Practice address

7051 Heathcote Village Way Ste 125
Gainesville, VA 20155-3198

Phone

(571) 237-4556

Fax

(833) 702-9006

NPI assigned

Jun 2, 2016

Organization subpart

No

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

Authorized official

Name

Douglas Robert McCracken, LPC

Title

Ceo

Phone

(571) 237-4556

Specialties & licenses 1

Addresses

Practitioners 3

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.

• Doug McCracken

  • Counselor
  • Gainesville, VA
  • NPI 1629106125
  NPD
• Madiha Khurshid

  • Mental Health Counselor
  • Manassas, VA
  • NPI 1982290797
  NPD (past)
• Jinok Lim, LMFT

  • Marriage & Family Therapist
  • Chantilly, VA
  • NPI 1063150407
  NPD (past)

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1699123380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7051 HEATHCOTE VILLAGE WAY STE 125",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553198",
            "telephone_number": "571-237-4556",
            "fax_number": "833-702-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7051 HEATHCOTE VILLAGE WAY STE 125",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553198",
            "telephone_number": "571-237-4556",
            "fax_number": "833-702-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX COUNSELINGGROUP AND PLAY THERAPYCENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-02",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "MCCRACKEN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "571-237-4556",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701004422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter T Pham OD, PLLC (Dr. Peter T Pham & Associates)
• Peter Tien Dzung Pham, O.D.
• VI Phan
• Pharmasutra PLLC (Gainesville Pharmacy)
• David Randell Phelps, APRN
• Phoenix Family Counseling & Play Therapy Center, PLLC
• Faline Phucas Davenport
• Michael R Pichardo, DDS
• Piedmont Professional Counseling
• Cecille M Pineda, PHARMD

• Mental Health Counselor in Gainesville, VA
• Providers in Gainesville, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.