DOMINION CENTER FOR BEHAVIORAL HEALTH SERVICES (NPI# 1043595770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043595770 |
| Entity Type | Organization |
| Organization Name | DOMINION CENTER FOR BEHAVIORAL HEALTH SERVICES |
| Practice Address |
43130 Amberwood Plz Suite 140 South Riding VA 20152-4105 |
| Practice Telephone | 7035427770 |
| Practice Fax Number | 7038762673 |
| Mailing Telephone | 7035427770 |
| Mailing Fax Number | 7038762673 |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2011-10-13 |
| Authorized Official Name | MR. WAYNE VILLENEUVE (CEO) |
| Authorized Official Telephone | 7035427770 |
| Authorized Official Credential | EDD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers | ||
| N | 103TF0000X |
Psychologist Specialization: Family |
Behavioral Health & Social Service Providers | ||
| N | 103TH0100X |
Psychologist Specialization: Health Service |
Behavioral Health & Social Service Providers | ||
| N | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
Behavioral Health & Social Service Providers | ||
| N | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
Behavioral Health & Social Service Providers | ||
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Dominion Center for Behavioral Health Services Ltd. | 43130 Amberwood Plaza, Suite 140, South Riding, Virginia 20152 |
| Street Address |
43130 AMBERWOOD PLZ SUITE 140 |
| City | SOUTH RIDING |
| State | VA |
| Zip Code | 20152-4105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508963141 | Janice Lynne Shubert | Social Worker | 43130 Amberwood Plz, Suite 140, South Riding, VA 20152-4105 | 2006-09-17 |
| 1902354814 | Chiron Physical Therapy of Va, LLC | Physical Therapist | 43130 Amberwood Plz, Suite 100, South Riding, VA 20152-4105 | 2016-09-20 |
| 1932652666 | Blue Skyy LLC | Physical Therapist | 43130 Amberwood Plz, Suite 100, South Riding, VA 20152-4105 | 2016-07-29 |
| 1013305747 | Casey Leann Davis | Psychologist | 43130 Amberwood Plz, Suite 140, South Riding, VA 20152-4105 | 2015-01-05 |
| 1386059988 | Stacey Nicole Lambour | Nurse Practitioner | 43130 Amberwood Plz, 140, South Riding, VA 20152-4105 | 2014-06-23 |
| 1205171790 | Andrea C Mettler Armstrong | Psychologist | 43130 Amberwood Plz, Suite 140, South Riding, VA 20152-4105 | 2012-12-10 |
| 1053665869 | Catherine Lander | Nurse Practitioner | 43130 Amberwood Plz, Suite 140, South Riding, VA 20152-4105 | 2012-10-31 |
| 1376816405 | Courtney Weaver | Social Worker | 43130 Amberwood Plz, Suite 140, South Riding, VA 20152-4105 | 2012-02-21 |
| 1396013173 | Amber L.s. Parker | Psychologist | 43130 Amberwood Plz, Suite 140, South Riding, VA 20152-4105 | 2011-12-07 |
| 1891062865 | Damon Marco Saunders | Social Worker | 43130 Amberwood Plz, South Riding, VA 20152-4105 | 2011-11-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528669751 | Joy Chirnside Mclaughlin | Physical Therapist | 26097 Iverson Drive, Chantilly, VA 20152 | 2020-11-04 |
| 1972132090 | Alissa S Rexo | Specialist | 25251 Beach Place, Chantilly, VA 20152 | 2020-04-02 |
| 1982178620 | South Riding Modern Dentistry, PC | Dentist | 25421 Lizzio Center Dr., Suite 190, Chantilly, VA 20152 | 2019-01-16 |
| 1154897627 | Nicole Hong | Dentist | 25273 Nesting Sq, Chantilly, VA 20152 | 2018-10-22 |
| 1437586369 | Chiron Physical Therapy LLC | Physical Therapist | 48130 Amberwood Plaza, Suite 100, South Riding, VA 20152 | 2013-10-10 |
| 1376772178 | Gloria Seon-young Kim | Dentist | 24805 Pinebrook Rd # 311, Chantilly, VA 20152 | 2009-07-14 |
| 1992955777 | Sohaib S. Elsayed | Family Medicine | 25055 Riding Plz Ste 220, South Riding, VA 20152 | 2008-09-29 |
| 1538328067 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 24795 Pinebrook Rd, South Riding, VA 20152 | 2008-06-09 |
| 1790970556 | Irfan Galaria | Plastic Surgery | 24805 Pinebrook Road, Suite #154, Chantilly, VA 20152 | 2007-09-13 |
| 1316150881 | Dina Gottesman | Pediatrics | 25055 Riding Plaza, Suite 150, South Riding, VA 20152 | 2007-05-08 |
| Find all providers in zip 20152 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558911321 | Ashley Frantz | Psychologist | 1901 Running Creek Ct, Virginia Beach, VA 23454-5775 | 2019-09-13 |
| 1487110383 | Rena Elizabeth Courtney | Psychologist | 1970 Roanoke Blvd # 116a6, Salem, VA 24153-6404 | 2019-02-15 |
| 1124548698 | Meredith Taylor Wilmer | Psychologist | 1487 Chain Bridge Rd Ste 203, Mc Lean, VA 22101-5723 | 2017-06-26 |
| 1619338050 | Lindsey Michelle Capon Dogali | Psychologist | 7207 Statecrest Dr, Annandale, VA 22003-1644 | 2016-03-13 |
| 1023441318 | Sharonda L Avery | Psychologist | 302 Torbert Loop, Stafford, VA 22554-8452 | 2013-08-09 |
| 1588921605 | Ramasamy Manikam | Psychologist | 25 Professional Way, Suite 101, Verona, VA 24482-2584 | 2012-04-13 |
| 1962795872 | Reston Center for Learning, LLC | Psychologist | 12007 Sunrise Valley Dr Ste 220, Reston, VA 20191-3446 | 2011-05-25 |
| 1356668156 | Turn of A Newleaf,inc | Psychologist | 9693 Hagel Circle, Lorton, VA 22079 | 2010-05-03 |
| 1275782013 | Jennifer Ann Berger | Psychologist | 3961 Blysdale Ln, Woodbridge, VA 22192-7445 | 2008-09-17 |
| 1184890204 | Peter Gould | Psychologist | 10615 Judicial Dr, 102, Fairfax, VA 22030-7501 | 2008-05-08 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH RIDING |
| Zip Code | 20152 |
Please comment or provide details below to improve the information on DOMINION CENTER FOR BEHAVIORAL HEALTH SERVICES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.