Active NPI
Vickie Jean Hagan, M.A., LPC, CSOPT
- Professional Counselor
- Leesburg, VA
National Provider Identifier
1053656629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701005378
- Practice address
- 21 Fort Evans Rd NE Ste B
Leesburg, VA 20176-4488 - Phone
- (703) 443-6917
- NPI assigned
- Dec 7, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701005378 | VA | Primary |
| Professional Counselor | 101YP2500X | C2976 | OR |
Addresses
Primary practice location
21 Fort Evans Rd NE Ste B
Leesburg, VA 20176-4488
Mailing address
P.O. Box 4696
Winchester, VA 22604
Phone (540) 931-7193
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C2976 | OR | MD | Professional Counselor |
| 0701005378 | VA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354838400000",
"number": "1053656629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 4696",
"city": "WINCHESTER",
"state": "VA",
"postal_code": "22604",
"telephone_number": "540-931-7193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 FORT EVANS RD NE STE B",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201764488",
"telephone_number": "703-443-6917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGAN",
"first_name": "VICKIE",
"middle_name": "JEAN",
"credential": "M.A., LPC, CSOPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-07",
"last_updated": "2012-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701005378",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C2976",
"primary": false
}
],
"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 Dec 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.