Active NPI
Maximo De la Cruz, QMHP-A-MA
- Mental Health Counselor
- Manassas, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 7530 Diplomat Dr Ste 101
Manassas, VA 20109-2682 - Phone
- (571) 572-0050
- Fax
- (888) 315-4281
- NPI assigned
- May 3, 2019
- Last updated
- Jan 20, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | VA | Primary | |
| 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
31 Ontell Ct
Stafford, VA 22554-1566
Phone (571) 572-0050
Other practice location 2
1930 Opitz Blvd
Woodbridge, VA 22191-3304
Phone (571) 572-0050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2002
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1303 Florida Ave
Woodbridge, VA 22191-3620
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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
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.
-
- Adolescent and Children Mental Health Clinic/Center
- Woodbridge, VA
- NPI 1366007460
-
- Clinical Child & Adolescent Psychologist
- Woodbridge, VA
- NPI 1861369977
-
- Clinic/Center
- Stafford, VA
- NPI 1013778760
-
- Clinical Child & Adolescent Psychologist
- Stafford, VA
- NPI 1205607744
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768867200000",
"number": "1043875248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 ONTELL CT",
"city": "STAFFORD",
"state": "VA",
"postal_code": "225541566",
"telephone_number": "571-572-0050",
"fax_number": "888-315-4281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7530 DIPLOMAT DR STE 101",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201092682",
"telephone_number": "571-572-0050",
"fax_number": "888-315-4281"
}
],
"practiceLocations": [
{
"address_1": "31 Ontell Ct",
"address_purpose": "LOCATION",
"city": "Stafford",
"state": "VA",
"postal_code": "225541566",
"country_code": "US",
"telephone_number": "571-572-0050",
"fax_number": "888-315-4281",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1930 Opitz Blvd",
"address_purpose": "LOCATION",
"city": "Woodbridge",
"state": "VA",
"postal_code": "221913304",
"country_code": "US",
"telephone_number": "571-572-0050",
"fax_number": "888-315-4281",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DE LA CRUZ",
"first_name": "MAXIMO",
"name_prefix": "Mr.",
"credential": "QMHP-A-MA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-03",
"last_updated": "2026-01-20",
"certification_date": "2026-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VA",
"license": null,
"primary": true
},
{
"code": "261QM0855X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adolescent and Children Mental Health",
"state": "VA",
"license": "3329-05-001",
"primary": false
},
{
"code": "261QM0855X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adolescent and Children Mental Health",
"state": "VA",
"license": "3329",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Manassas, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.