Individual provider Active NPI

Desiree Roberts, LPC

  • Professional Counselor
  • Fairfax, VA
National Provider Identifier
1033524525
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701007493 Issued in VA
Practice address
8221 Willow Oaks Corporate Dr
Fairfax, VA 22031-4512
Phone
(703) 559-3000
NPI assigned
Jun 24, 2014
Last updated
Jan 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 0701007493 VA
Professional Counselor 101YP2500X 0701007493 VA Primary

Addresses

Primary practice location

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031-4512

Mailing address

673 Potomac Station Dr NE # 701
Leesburg, VA 20176-1819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240113000772 DC Practitioner - Mental Health Counselor 9436501558 Reassigns benefits to 1 organization
I20260422002878 TX Practitioner - Mental Health Counselor 9436501558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

440 N Barranca Ave
Covina, CA 91723-1722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701007493VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax County, Virginia Single Specialty CurrentSince Jan 1, 2024 Accepting new patients
Inova Health Care Services Single Specialty PastSince Sep 1, 2020 Accepting new patients
Inova Health Care Services Single Specialty PastSince Sep 1, 2020 Accepting new patients

Locations

12011 Government Center Pkwy
Ste 836
Fairfax, VA 22035
Phone (703) 324-3360

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031
Phone (703) 289-7599

8221 Willow Oaks Corporate Dr
Ste 4425
Fairfax, VA 22031
Phone (703) 289-7599

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1033524525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 POTOMAC STATION DR NE # 701",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201761819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8221 WILLOW OAKS CORPORATE DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314512",
            "telephone_number": "703-559-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "DESIREE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701007493",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701007493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.