Prince William Community Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

0904000578 Issued in VA

Legal business name

PRINCE WILLIAM COMMUNITY SERVICES

Practice address

7762 Donegan Dr
Manassas, VA 20109-2868

Phone

(703) 792-4935

NPI assigned

Jan 14, 2017

Organization subpart

No

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

Authorized official

Name

Alan Wooten, MPA

Title

Executive Director

Phone

(703) 792-7894

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Harry Hogshead, LCSW

  • Clinical Social Worker
  • Manassas, VA
  • NPI 1508570896
  NPD (past)
• Hyung Soon Park, MD

  • Psychiatry Physician
  • Woodbridge, VA
  • NPI 1669554267
  NPD (past)

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

{
    "created_epoch": "1484352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484352000000",
    "number": "1902342934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8033 ASHTON AVE",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092895",
            "telephone_number": "703-792-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7762 DONEGAN DR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092868",
            "telephone_number": "703-792-4935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCE WILLIAM COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-14",
        "last_updated": "2017-01-14",
        "status": "A",
        "authorized_official_last_name": "WOOTEN",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "703-792-7894",
        "authorized_official_credential": "MPA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "0904000578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janine Prime, NP
• Primedoc of Manassas PC
• Prince Wiliam Family Counseling, PC
• Prince William Ambulatory Surgery Center, LLC
• Prince William Cardiology Associates
• Prince William County Community Services Board
• Prince William County Community Services Board
• Prince William County Community Services Board
• Prince William County Community Services Board
• Prince William County Community Services Board

• Community/Behavioral Health Agency in Manassas, VA
• Providers in Manassas, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.