NPIMap

Organization Active NPI

Phoenix Family Counseling & Play Therapy Center, PLLC

  • Clinical Social Worker
  • Gainesville, VA
National Provider Identifier
1831264738
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904003525 Issued in VA
Legal business name
PHOENIX FAMILY COUNSELING & PLAY THERAPY CENTER, PLLC
Practice address
7404 Gallerher Rd
Suite 100
Gainesville, VA 20155
Phone
(703) 909-8963
Fax
(703) 753-5193
NPI assigned
Nov 24, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mary Catherine Spooner, LCSWNPI 1194738237
Title
Director
Phone
(703) 909-8963

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
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X 0904003525 VA Primary

Addresses

Primary practice location

7404 Gallerher Rd
Suite 100
Gainesville, VA 20155

Mailing address

4350 Snow Hill Dr.
Gainesville, VA 20155
Phone (703) 909-8963

National Provider Directory

National Provider Directory

Locations

7350 Heritage Village Plz
Unit 201
Gainesville, VA 20155
Phone (571) 248-0626

7404 Gallerher Rd
#100
Gainesville, VA 20155
Phone (703) 216-5230

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831264738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 SNOW HILL DR.",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "20155",
            "telephone_number": "703-909-8963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7404 GALLERHER RD",
            "address_2": "SUITE 100",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "20155",
            "telephone_number": "703-909-8963",
            "fax_number": "703-753-5193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX FAMILY COUNSELING & PLAY THERAPY CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPOONER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "703-909-8963",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904003525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.