CARL STREET (NPI# 1720450943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720450943 |
| Entity Type | Individual |
| Full Name | CARL STREET |
| Credential | LPC |
| Practice Address |
11835 Hazel Circle Dr Bristow VA 20136-2180 |
| Mailing Address |
14488 Sharpshinned Dr Gainesville VA 20155-5837 |
| Practice Telephone | 7036365100 |
| Mailing Telephone | 7037537229 |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2015-10-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 0701005656 | VA | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
0718000249 | VA | Behavioral Health & Social Service Providers |
| Street Address |
11835 HAZEL CIRCLE DR |
| City | BRISTOW |
| State | VA |
| Zip Code | 20136-2180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316118292 | Youth for Tomorrow New Life Center, Inc. | Counselor | 11835 Hazel Circle Dr, Bristow, VA 20136-2180 | 2008-03-18 |
| 1750907762 | Christen Panissidi | Social Worker | 11835 Hazel Circle Dr, Bristow, VA 20136-1223 | 2020-06-25 |
| 1760019376 | Deandra Lynn Payne-allen | Counselor | 11835 Hazel Circle Dr, Bristow, VA 20136-1223 | 2020-03-24 |
| 1285260315 | Elvia Del Carmen Pina | Counselor | 11835 Hazel Circle Dr, Bristow, VA 20136-2180 | 2020-03-20 |
| 1902370109 | Youth for Tomorrow New Life Center, Inc. | Clinic/Center | 11835 Hazel Circle Dr, Bristow, VA 20136-2180 | 2019-01-22 |
| 1033604368 | Natalia Becker | Counselor | 11835 Hazel Circle Dr, Bristow, VA 20136-1223 | 2018-06-28 |
| 1184145310 | Meagan A Caesar | Counselor | 11835 Hazel Circle Dr, Bristow, VA 20136-2180 | 2017-06-28 |
| 1124478979 | Jessica Renee Miller | Social Worker | 11835 Hazel Circle Dr, Bristow, VA 20136-1223 | 2016-06-13 |
| 1144619305 | Naomi Britton | Counselor | 11835 Hazel Circle Dr, Bristow, VA 20136-2180 | 2015-01-12 |
| 1265775241 | Youth for Tomorrow New Life Center Inc | Community/Behavioral Health | 11835 Hazel Circle Dr, Bristow, VA 20136-2180 | 2013-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518405802 | Dharika Bhavsar | Nurse Practitioner | 12207 Desoto Falls Ct, Bristow, VA 20136 | 2017-02-07 |
| 1902284649 | Paul Choi | Physical Therapist | 6858 Old Dominion Drive, Mclean, VA 20136 | 2015-05-14 |
| 1700123031 | Sunlight Home Care Agency | Home Health | 8902 Stable Forest Pl, Bristow, VA 20136 | 2013-01-07 |
| 1437407996 | Elizabeth Michelle Bender | Specialist/Technologist | 12171 Hopper Lane, Bristow, VA 20136 | 2012-08-15 |
| 1477793966 | Pediatrics First Speech Therapy | Speech-Language Pathologist | 10056 Pentland Hills Way, Bristow, VA 20136 | 2009-02-24 |
| 1750599247 | Harris Teeter, LLC | Pharmacy | 10438 Bristow Center Dr., Bristow, VA 20136 | 2007-05-18 |
| 1588760490 | Margaret Precious Neal-stubblefield | Dentist | 12701 Braemar Village Plaza, Bristow, VA 20136 | 2006-09-16 |
| 1538726203 | Brightstone, LLC | Family Medicine | 10040 Pentland Hills Way, Bristow, VA 20136 | 2019-05-28 |
| 1578766036 | Kevin Wade Toms | Dentist | 9070 Devlin Rd, #140, Bristow, VA 20136-1041 | 2007-06-11 |
| 1407011869 | Michelle Klima Toms | Dentist | 9070 Devlin Rd, Suite 140, Bristow, VA 20136-1041 | 2008-07-25 |
| Find all providers in zip 20136 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679815245 | Samantha Marie Lancaster | Counselor | 313 E 6th Ave, Bristow, OK 74010-3005 | 2013-03-21 |
| 1710110564 | Nada Girgis | Counselor | 9801 Nugget Ct, Bristow, VA 20136-2430 | 2009-08-27 |
| 1629106125 | Doug Mccracken | Counselor | 9560 Linton Hall Rd, Bristow, VA 20136-1218 | 2007-02-28 |
| 1710325949 | Cheyenne Rose Cheatwood | Counselor | 109 N Main St, Bristow, OK 74010-2429 | 2013-06-10 |
| 1336388321 | Safe Harbor Christian Counseling | Counselor | 9560 Linton Hall Rd, Bristow, VA 20136-1218 | 2009-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831790229 | Candice Cornelio | Counselor | 1904 Tolbert Ter Apt 202, Chester, VA 23836-2824 | 2020-11-03 |
| 1306443619 | Helianthus Therapy Services, LLC | Counselor | 767 Madison Rd Ste 112-114, Culpeper, VA 22701-3379 | 2020-10-08 |
| 1477160471 | Sarah Chun | Counselor | 950 N Washington St # 322, Alexandria, VA 22314-1534 | 2020-09-24 |
| 1659983484 | A. Lawrence Christian Counseling LLC | Counselor | 8213 Sudley Rd Ste 202, Manassas, VA 20109-3507 | 2020-08-22 |
| 1578173993 | Marjorie Denise Handy | Counselor | 108 Joyce Rd, Bassett, VA 24055-6102 | 2020-08-01 |
| 1073122719 | David Wooden | Counselor | 4201 Wilson Blvd # 300, Arlington, VA 22203-4417 | 2020-07-29 |
| 1376152678 | Gwendolyn Maurice | Counselor | 739 Cherry Hill Rd, Heathsville, VA 22473-2648 | 2020-07-23 |
| 1922624154 | Cedric Wilson | Counselor | 2616 Stonegate Dr, Winchester, VA 22601-3482 | 2020-06-23 |
| 1154946291 | Chloe Fulcher Morrissett | Counselor | 8389 Reagan Dr, King George, VA 22485-7149 | 2020-06-15 |
| 1184248130 | Thomas Lafayette Bateman IIi | Counselor | 11025 Greenline Ct, Mechanicsville, VA 23116-5855 | 2020-06-05 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CARL STREET.
| 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.