Organization
PROSPERITY EATING DISORDER AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER NELSON BAKER LCSW (CEO)
(703) 466-5150
Entity
Organization
Contact information
Practice address
1897 PRESTON WHITE DR STE 300, RESTON, VA 20191-5479
(703) 466-5150
(703) 649-3599
Mailing address
1897 PRESTON WHITE DR STE 300, RESTON, VA 20191-5479
(703) 466-5150
(703) 649-3559
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/30/2014
Last updated
06/17/2025
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