Maximo De la Cruz, QMHP-A-MA
Individual provider Active NPI Mental Health Counselor · Manassas, VA
NPI 1043875248 · NPPES record last updated Jan 20, 2026
Key facts
- NPI
- 1043875248
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 7530 Diplomat Dr Ste 101
Manassas, VA 20109-2682 - Phone
- (571) 572-0050
- Fax
- (888) 315-4281
- NPI assigned
- May 3, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2002
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1303 Florida Ave
Woodbridge, VA 22191-3620
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260217001089 | VA | Practitioner - Mental Health Counselor | 8729568985 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3329 | VA | MD | Adolescent and Children Mental Health Clinic/Center |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Absolute Mental Health Clinic LLC | Adolescent and Children Mental Health | Current |
Accepting new patients |
| Absolute Mental Health Clinic LLC | Current | Accepting new patients |
Locations
1930 Opitz Blvd
Woodbridge, VA 22191
Phone (703) 497-9950
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | VA | Yes | |
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | 3329-05-001 | VA | |
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | 3329 | VA |
Addresses
Primary practice location
7530 Diplomat Dr Ste 101
Manassas, VA 20109-2682
Mailing address
31 Ontell CT
Stafford, VA 22554-1566
Phone (571) 572-0050
Other practice location 1
1930 Opitz Blvd
Woodbridge, VA 22191-3304
Phone (571) 572-0050
Other practice location 2
31 Ontell Ct
Stafford, VA 22554-1566
Phone (571) 572-0050
Other providers in Manassas, VA
- Robert George Davis
- Tod R Davis
- Leslie A Davy
- Kathleen Nicole Dawood
- Flaviano Delacruz Dazo
- Madison Nicole De Leon
- Allannah Deahl
- Stella A Deakos
- Michele Landry Dearment
- David Alan Debenedetto
All providers in Manassas, VA · Mental Health Counselor in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.