Organization Active NPI

Restorative Therapeutic Services

  • Counselor
  • Reston, VA
National Provider Identifier
1750714382
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LC4739 Issued in MD
Legal business name
RESTORATIVE THERAPEUTIC SERVICES
Practice address
12020 Sunrise Valley Dr Ste 100
Reston, VA 20191-3429
Phone
(703) 884-7517
NPI assigned
Aug 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Authorized official

Name
Anthonia Levy
Title
Managing Director
Phone
(703) 884-7517

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X LC4739 MD Primary

Addresses

Primary practice location

12020 Sunrise Valley Dr Ste 100
Reston, VA 20191-3429

Mailing address

12020 Sunrise Valley Dr Ste 100
Reston, VA 20191-3429
Phone (703) 884-7517

Other identifiers 2

IdentifierTypeStateIssuer
AK37OtherCARE FIRST
0591041 00MedicaidMD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475020800000",
    "number": "1750714382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12020 SUNRISE VALLEY DR STE 100",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913429",
            "telephone_number": "703-884-7517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12020 SUNRISE VALLEY DR STE 100",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913429",
            "telephone_number": "703-884-7517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATIVE THERAPEUTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-19",
        "last_updated": "2016-09-28",
        "status": "A",
        "authorized_official_last_name": "LEVY",
        "authorized_official_first_name": "ANTHONIA",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "703-884-7517"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "MD",
            "license": "LC4739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST",
            "identifier": "AK37",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0591041 00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; 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.