=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861261752
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRIME MENTAL HEALTH & WELLNESS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2023
-----------------------------------------------------
Last Update Date | 10/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 392 GARRISONVILLE RD STE 210B
-----------------------------------------------------
City | STAFFORD
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22554-1576
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-930-4063
-----------------------------------------------------
Fax | 540-930-4066
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 392 GARRISONVILLE RD STE 210B
-----------------------------------------------------
City | STAFFORD
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22554-1576
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-930-4063
-----------------------------------------------------
Fax | 540-930-4066
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PMHNP-BC
-----------------------------------------------------
Name | MRS. AKUA AMPONSAH-ADJEI
-----------------------------------------------------
Credential | PMHNP-BC
-----------------------------------------------------
Telephone | 540-930-4063
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------