Individual provider Active NPI

Andrea Beth McCormack, LPC

  • Mental Health Counselor
  • Centreville, VA
National Provider Identifier
1093925141
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701007134 Issued in VA
Practice address
5675 Stone Rd Ste 310
Centreville, VA 20120-1667
Phone
(816) 405-7499
NPI assigned
May 23, 2007
Last updated
Aug 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0701007134 VA Primary
Professional Counselor 101YP2500X 0701007134 VA

Addresses

Primary practice location

5675 Stone Rd Ste 310
Centreville, VA 20120-1667

Mailing address

6165 Gothwaite Drive
Centreville, VA 20120-1817
Phone (816) 405-7499

Other identifiers 1

IdentifierTypeStateIssuer
3001745073001MedicaidVA

Other names 1

  • Andrea Beth Schwensen Former name

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
I20251121004501 DC Practitioner - Mental Health Counselor 0244722759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10719 Scott Dr
Fairfax, VA 22030-3022

6165 Gothwaite Dr
Centreville, VA 20120-1817

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701007134VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Happy Healthy Healing PLLC Professional CurrentSince Oct 1, 2025 Accepting new patients

Locations

5675 Stone Rd
Ste 310
Centreville, VA 20120
Phone (703) 802-7521

Organizations & group practices 1

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1093925141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6165 GOTHWAITE DRIVE",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201201817",
            "telephone_number": "816-405-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5675 STONE RD STE 310",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201201667",
            "telephone_number": "816-405-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "ANDREA",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2025-08-06",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701007134",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701007134",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3001745073001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "SCHWENSEN",
            "middle_name": "BETH",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Centreville, VA

Sources for this page

Verify at the official NPI Registry.