Individual provider Active NPI

Dekiegai Eleazer Reeves

  • Mental Health Counselor
  • Woodbridge, VA
National Provider Identifier
1003516980
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
14786 Barksdale St
Woodbridge, VA 22193-1704
Phone
(703) 864-4561
NPI assigned
Mar 8, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

14786 Barksdale St
Woodbridge, VA 22193-1704

Mailing address

14786 Barksdale St
Woodbridge, VA 22193-1704
Phone (703) 864-4561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1003516980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14786 BARKSDALE ST",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221931704",
            "telephone_number": "703-864-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14786 BARKSDALE ST",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221931704",
            "telephone_number": "703-864-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVES",
        "first_name": "DEKIEGAI",
        "middle_name": "ELEAZER",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.