Organization Active NPI

The Brain Clinic LLC

  • Clinical Neuropsychologist
  • Abingdon, VA
National Provider Identifier
1962351510
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
THE BRAIN CLINIC LLC
Practice address
188 E Main St Ste 1a
Abingdon, VA 24210-2857
Phone
(276) 289-3003
Fax
(276) 289-3022
NPI assigned
Jan 27, 2026
Last updated
Apr 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Authorized official

Name
Kristen Smith
Title
Credentialing Specialist
Phone
(276) 821-2260

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Neuropsychologist 103G00000X NU Primary
Adult Development & Aging Psychologist 103TA0700X NU
Cognitive & Behavioral Psychologist 103TB0200X NU
Clinical Psychologist 103TC0700X NU

Addresses

Primary practice location

188 E Main St Ste 1a
Abingdon, VA 24210-2857

Mailing address

201 E Main St Ste 203
Abingdon, VA 24210-2903
Phone (276) 289-3003

Other practice location 1

201 E Main St Ste 203
Abingdon, VA 24210-2903
Phone (276) 289-3003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260427001505 VA Part B Supplier - Clinic/Group Practice 3971070087 Receives reassigned benefits from 2 practitioners
Practice locations: Abingdon, VA

National Provider Directory

National Provider Directory

Locations

201 E Main St
Ste 203
Abingdon, VA 24210
Phone (276) 289-3003

Practitioners & affiliated clinicians

Practitioners 2

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": "1769472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775520000000",
    "number": "1962351510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E MAIN ST STE 203",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242102903",
            "telephone_number": "276-289-3003",
            "fax_number": "276-289-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 E MAIN ST STE 1A",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242102857",
            "telephone_number": "276-289-3003",
            "fax_number": "276-289-3022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 E Main St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242102903",
            "country_code": "US",
            "telephone_number": "276-289-3003",
            "fax_number": "276-289-3022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE BRAIN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-27",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "276-821-2260"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.