Individual provider Active NPI

Cameron Gregory Mittelman

  • Counselor
  • Manassas, VA
National Provider Identifier
1154567576
Registry record updated Jan 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
10651 Lomond Dr
Manassas, VA 20109-2808
Phone
(703) 369-2976
Fax
(703) 366-2777
NPI assigned
Jan 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

10651 Lomond Dr
Manassas, VA 20109-2808

Mailing address

10651 Lomond Dr
Manassas, VA 20109-2808
Phone (703) 369-2976

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

Practice roles

OrganizationSpecialtyStatusNew patients
Matthews Center for Visual Learning Past Accepting new patients
Matthew'S Center for Visual Learning Past Accepting new patients

Organizations & group practices 2

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": "1231286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231286400000",
    "number": "1154567576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10651 LOMOND DR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092808",
            "telephone_number": "703-369-2976",
            "fax_number": "703-366-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10651 LOMOND DR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092808",
            "telephone_number": "703-369-2976",
            "fax_number": "703-366-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTELMAN",
        "first_name": "CAMERON",
        "middle_name": "GREGORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-07",
        "last_updated": "2009-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; 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.