Individual provider Active NPI

Carlton Mack

  • Counselor
  • Leesburg, VA
National Provider Identifier
1013800101
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
222 Catoctin Cir SE FL 2
Leesburg, VA 20175-3730
Phone
(571) 609-5351
NPI assigned
May 29, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X VA Primary

Addresses

Primary practice location

222 Catoctin Cir SE FL 2
Leesburg, VA 20175-3730

Mailing address

20814 Confidence CT
Ashburn, VA 20147-3924
Phone (703) 926-9470

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": "1748476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1013800101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20814 CONFIDENCE CT",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201473924",
            "telephone_number": "703-926-9470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 CATOCTIN CIR SE FL 2",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201753730",
            "telephone_number": "571-609-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "CARLTON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-29",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; 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.