Video Therapy

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

3175-A Issued in NC

Legal business name

VIDEO THERAPY

Practice address

4208 Six Forks Rd Ste 1000
Raleigh, NC 27609-5738

Phone

(919) 758-4559

Fax

(919) 573-0442

NPI assigned

Jul 9, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Sabriya Laila Sharif-Hanifa, MS, LCASA

Title

Ceo

Phone

(919) 758-4559

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1436400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436400000000",
    "number": "1851774715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4749 COURTNEY LN APT F",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276165250",
            "telephone_number": "919-758-4559",
            "fax_number": "919-573-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 SIX FORKS RD STE 1000",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095738",
            "telephone_number": "919-758-4559",
            "fax_number": "919-573-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDEO THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-09",
        "last_updated": "2015-07-09",
        "status": "A",
        "authorized_official_last_name": "SHARIF-HANIFA",
        "authorized_official_first_name": "SABRIYA",
        "authorized_official_middle_name": "LAILA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-758-4559",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, LCASA"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NC",
            "license": "3175-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Victory Wellness LLC
• Vida Counseling, PLLC
• Videri Counseling Services PLLC
• Kaitlyn Elizabeth Viera, MSW, LCSWA
• Daniel Robert Vig, MD
• Jeanin R. Vignjevic-Godbolt, PTA
• Deepa Vijay, MD

• Health Maintenance Organization in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Health Maintenance Organization in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; 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.