Active NPI
The Brain Clinic LLC
- Clinical Neuropsychologist
- Abingdon, VA
National Provider Identifier
1962351510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- 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, 2026
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider DirectoryLocations
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.
-
- Professional Counselor
- Cedar Bluff, VA
- NPI 1184762452
-
- Clinical Neuropsychologist
- Abingdon, VA
- NPI 1083000798
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.