1200 West LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

1200 WEST LLC

Practice address

106 Southpark Dr Ste C
Blacksburg, VA 24060-6809

Phone

(540) 376-3348

NPI assigned

Oct 16, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Fred Milacci, D.ED

Title

Owner

Phone

(434) 944-0487

Specialties & licenses 1

Addresses

Other names 1

• Thriveworks Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tara Brewster Lineberry, LCSW

  • Clinical Social Worker
  • Wytheville, VA
  • NPI 1619506367
  NPD (past)

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508112000000",
    "number": "1871004077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 CREEKVIEW CT",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245025341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 SOUTHPARK DR STE C",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240606809",
            "telephone_number": "540-376-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1200 WEST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-16",
        "last_updated": "2017-10-16",
        "status": "A",
        "authorized_official_last_name": "MILACCI",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-944-0487",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.ED"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thriveworks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Sofia Elainne Abraham-Hardee, D.O/PHD

• Mental Health Counselor in Blacksburg, VA
• Providers in Blacksburg, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2017; 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.