Fredericksburg Area Health and Support Services

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

FREDERICKSBURG AREA HEALTH AND SUPPORT SERVICES

Doing business as

Mosaic Care Center

Practice address

10514 Wakeman Dr
Fredericksburg, VA 22407-8040

Phone

(540) 993-4473

NPI assigned

Jun 2, 2022

Organization subpart

Yes

Parent organization

FREDERICKSBURG AREA HEALTH AND SUPPORT SERVICESAs reported in NPPES

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

Authorized official

Name

Joseph Lyttle

Title

Executive Director

Phone

(540) 907-4555

Specialties & licenses 1

Addresses

Other names 2

• Mosaic Care Center Doing business as
• Fredericksburg Area HIV/AIDS Support Services Former legal business name

Electronic endpoints 1

Tax ID family

Fredericksburg Area Hivaids Support Services Fahass3 organizations share this tax ID, including this one

Part of

Fredericksburg Area Hivaids Support Services Fahass

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Fredericksburg Area Health and Support Services

  • Case Management Agency
  • Fredericksburg, VA
  • NPI 1053516344
  NPD tax ID
• Fredericksburg Area Health and Support Services

  dba Mosaic Care Center

  • Family Nurse Practitioner
  • Fredericksburg, VA
  • NPI 1104170398
  NPD tax ID

Locations

Interoperability endpoints

• Direct secure messaging: behavioral.health.services.8@20704.direct.athenahealth.com

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1851030274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 PLANK RD STE 100",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224074807",
            "telephone_number": "540-993-4473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10514 WAKEMAN DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224078040",
            "telephone_number": "540-993-4473"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4343 Plank Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224074807",
            "country_code": "US",
            "telephone_number": "540-907-4555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FREDERICKSBURG AREA HEALTH AND SUPPORT SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREDERICKSBURG AREA HEALTH AND SUPPORT SERVICES",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A",
        "authorized_official_last_name": "LYTTLE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "540-907-4555"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "behavioral.health.services.8@20704.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Behavioral Health Services",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10514 Wakeman Dr",
            "city": "Fredericksburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "224078040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mosaic Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fredericksburg Area HIV/AIDS Support Services",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Fredericksburg Area HIV/AIDS Support Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Fredericksburg
• Fredericksburg Ambulatory Surgery Center, LLC
• Fredericksburg Anesthesia Services, LLC
• Fredericksburg Area Health and Support Services
• Fredericksburg Area Health and Support Services (Mosaic Care Center)
• Fredericksburg Area Regional Health Council (Lloyd F Moss Free Clinic Pharmacy)
• Fredericksburg Area Regional Health Council (Lloyd F. Moss Free Clinic)
• Fredericksburg Christian Health Center
• Fredericksburg City Pharmacy Inc
• Fredericksburg Dental Care

• Clinical Social Worker in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.