Individual provider Active NPI

Sindhura Elagandhala

  • Professional Counselor
  • McLean, VA
National Provider Identifier
1043937857
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0704015352 Issued in VA
Practice address
1311 Dolley Madison Blvd BLDG a
MC Lean, VA 22101-3937
Phone
(571) 536-7741
NPI assigned
Oct 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0704015352 VA Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

1311 Dolley Madison Blvd BLDG a
MC Lean, VA 22101-3937

Mailing address

8133 Leesburg Pike Ste 130
Tysons, VA 22182-2706

Other practice location 1

8133 Leesburg Pike Ste 130
Tysons, VA 22182-2706
Phone (720) 938-0507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260624002251 DC Practitioner - Mental Health Counselor 2163995846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

803 Sunken Rd
Fredericksburg, VA 22401-5401

PO Box
Atlanta, GA 30374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0704015352VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ayrielle Williams, LLC Mental Health CurrentSince Oct 1, 2022 Accepting new patients
Peaceful Place Mental Health CurrentSince Oct 1, 2022 Accepting new patients

Locations

8133 Leesburg Pike
Ste 130
Vienna, VA 22182
Phone (703) 682-0163

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1043937857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8133 LEESBURG PIKE STE 130",
            "city": "TYSONS",
            "state": "VA",
            "postal_code": "221822706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 DOLLEY MADISON BLVD BLDG A",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013937",
            "telephone_number": "571-536-7741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8133 Leesburg Pike Ste 130",
            "address_purpose": "LOCATION",
            "city": "Tysons",
            "state": "VA",
            "postal_code": "221822706",
            "country_code": "US",
            "telephone_number": "720-938-0507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELAGANDHALA",
        "first_name": "SINDHURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0704015352",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

Verify at the official NPI Registry.