PROSPERITY EATING DISORDER AND WELLNESS NPI 1043613474

NPI Information

  • NPI: 1043613474
  • Provider Name: PROSPERITY EATING DISORDER AND WELLNESS
  • Classification: Clinic/Center - 261QM0855X
  • Specialization: Adolescent and Children Mental Health
  • Entity Type: Organization
  • Address: 1897 PRESTON WHITE DR STE 300
    RESTON, VA
    ZIP 20191
  • Phone: (703) 466-5150

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NPI Details

PROSPERITY EATING DISORDER AND WELLNESS is an adolescent and children mental health clinic center in Reston, VA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. PROSPERITY EATING DISORDER AND WELLNESS NPI is 1043613474. The provider is registered as an organization entity type.

The provider's business location address is:

1897 PRESTON WHITE DR STE 300
RESTON, VA
ZIP 20191-479
Phone: (703) 466-5150
Fax: (703) 649-3599

The provider's authorized official is Heather Nelson Baker .
The authorized official title is Ceo and has the following contact phone number (703) 466-5150.

The enumeration date for this NPI number is 9/30/2014 and was last updated on 6/17/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0850XClinic/CenterAdult Mental HealthNo
2261QM0855XClinic/CenterAdolescent and Children Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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