Active NPI
Deshia Adubofour
- Marriage & Family Therapist
- Manassas Park, VA
National Provider Identifier
1154040509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 0717002495
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 881852792 | Other | FL | THERAPY SERVICES |
Other names 1
- Deshia Holmes
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0717002495 | VA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brookside Family Therapy, LLC | Marriage & Family Therapist | Current | 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.
-
- Mental Health Counselor
- Manassas, VA
- NPI 1477323152
Marriage & Family Therapist
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.