# KAMPIEDA MEDICAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255921847
- **Authorized official:** GISSELLA MANA AGACNP-BC, PMHNPBC (OWNER)
- **Authorized official phone:** (540) 446-2610

## Contact information

- **Practice address:** 8300 BOONE BLVD \# 573, VIENNA, VA 22182-2626
- **Practice address phone:** (540) 446-2610
- **Practice address fax:** (540) 446-2612
- **Mailing address:** 281 PEAR BLOSSOM RD, STAFFORD, VA 22554-2531
- **Mailing address phone:** (540) 446-2610
- **Mailing address fax:** (540) 446-2612

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 133VN1201X | Obesity and Weight Management Nutrition Registered Dietitian | — | NULL | — |
| 133VN1201X | Obesity and Weight Management Nutrition Registered Dietitian | — | — | — |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 163WI0500X | Infusion Therapy Registered Nurse | — | NULL | — |
| 163WI0500X | Infusion Therapy Registered Nurse | — | — | — |
| 163WP0807X | Child & Adolescent Psychiatric/Mental Health Registered Nurse | — | NULL | — |
| 163WP0807X | Child & Adolescent Psychiatric/Mental Health Registered Nurse | — | — | — |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | — |
| 171M00000X | Case Manager/Care Coordinator | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207RH0002X | Hospice and Palliative Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RH0002X | Hospice and Palliative Medicine (Internal Medicine) Physician | — | — | — |
| 2083B0002X | Obesity Medicine (Preventive Medicine) Physician | — | NULL | — |
| 2083B0002X | Obesity Medicine (Preventive Medicine) Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |
| 2084P0805X | Geriatric Psychiatry Physician | — | NULL | — |
| 2084P0805X | Geriatric Psychiatry Physician | — | — | — |
| 2084S0012X | Sleep Medicine (Psychiatry & Neurology) Physician | — | NULL | — |
| 2084S0012X | Sleep Medicine (Psychiatry & Neurology) Physician | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/19/2021
- **Last updated:** 09/27/2025