Individual provider Active NPI

Deshia Adubofour

  • Marriage & Family Therapist
  • Manassas Park, VA
National Provider Identifier
1154040509
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
0717002495 Issued in VA
Practice address
9105A Owens Dr Ste 102
Manassas Park, VA 20111-4852
Phone
(571) 445-0265
NPI assigned
Aug 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0717002495 VA Primary

Addresses

Primary practice location

9105A Owens Dr Ste 102
Manassas Park, VA 20111-4852

Mailing address

2108 Hemlock Bay Rd
Dumfries, VA 22026-2954

Other practice location 1

7118 Knotty Oak Ln
Manassas, VA 20112-3235
Phone (571) 331-9704

Other practice location 2

2108 Hemlock Bay Rd
Dumfries, VA 22026-2954
Phone (571) 946-0834

Other identifiers 1

IdentifierTypeStateIssuer
881852792OtherFLTHERAPY SERVICES

Other names 1

  • Deshia Holmes Former name

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

State licenses

LicenseStateTypeSpecialty
0717002495VAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brookside Family Therapy, LLC Marriage & Family Therapist CurrentSince Jan 7, 2024 Accepting new patients

Locations

9105A Owens Dr
Ste 102
Manassas Park, VA 20111
Phone (571) 331-9704

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1154040509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 HEMLOCK BAY RD",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220262954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9105A OWENS DR STE 102",
            "city": "MANASSAS PARK",
            "state": "VA",
            "postal_code": "201114852",
            "telephone_number": "571-445-0265"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7118 Knotty Oak Ln",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201123235",
            "country_code": "US",
            "telephone_number": "571-331-9704",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2108 Hemlock Bay Rd",
            "address_purpose": "LOCATION",
            "city": "Dumfries",
            "state": "VA",
            "postal_code": "220262954",
            "country_code": "US",
            "telephone_number": "571-946-0834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADUBOFOUR",
        "first_name": "DESHIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-26",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717002495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THERAPY SERVICES",
            "identifier": "881852792",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESHIA",
            "last_name": "HOLMES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manassas Park, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.