Active NPI
Pimmit Counseling & Wellness Clinic PLLC
- Professional Counselor
- Vienna, VA
National Provider Identifier
1740386762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701002934
- Legal business name
- PIMMIT COUNSELING & WELLNESS CLINIC PLLC
- Practice address
- 2235 Cedar LN Ste 102
Vienna, VA 22182-5247 - Phone
- (703) 556-4888
- Fax
- (703) 556-7774
- NPI assigned
- Sep 16, 2006
- Last updated
- Oct 18, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Shahrzad Poorshaghaghi, ED.D, LPC, NCC
- Title
- Owner
- Phone
- (703) 556-4888
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701002934 | VA | Primary |
| Behavior Analyst | 103K00000X |
Addresses
Primary practice location
2235 Cedar LN Ste 102
Vienna, VA 22182-5247
Mailing address
2235 Cedar LN Ste 102
Vienna, VA 22182-5247
Phone (703) 556-4888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005411165 | Medicaid | VA |
Other names 1
- Pimmit Counseling & Wellness Clinic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
2235 Cedar Ln
Ste 102
Vienna, VA 22182
Phone (703) 350-8760
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Psychiatry Physician
- Falls Church, VA
- NPI 1629463187
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1666051200000",
"number": "1740386762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2235 CEDAR LN STE 102",
"city": "VIENNA",
"state": "VA",
"postal_code": "221825247",
"telephone_number": "703-556-4888",
"fax_number": "703-556-7774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2235 CEDAR LN STE 102",
"city": "VIENNA",
"state": "VA",
"postal_code": "221825247",
"telephone_number": "703-556-4888",
"fax_number": "703-556-7774"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PIMMIT COUNSELING & WELLNESS CLINIC PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-16",
"last_updated": "2022-10-18",
"certification_date": "2022-10-18",
"status": "A",
"authorized_official_last_name": "POORSHAGHAGHI",
"authorized_official_first_name": "SHAHRZAD",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "703-556-4888",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "ED.D, LPC, NCC"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701002934",
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005411165",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Pimmit Counseling & Wellness Clinic",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Vienna, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.