Individual provider Active NPI

Tamara La Shaun Carter, LPC

  • Professional Counselor
  • Stafford, VA
National Provider Identifier
1154940617
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701008963 Issued in VA
Practice address
9 Fountain Dr
Stafford, VA 22554-7298
Phone
(571) 206-8078
NPI assigned
Apr 14, 2020
Last updated
Jun 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701008963 VA Primary

Addresses

Primary practice location

9 Fountain Dr
Stafford, VA 22554-7298

Mailing address

9 Fountain Dr
Stafford, VA 22554-7298

Other practice location 1

13000 Harbor Center Dr Ste 362
Woodbridge, VA 22192-2846
Phone (703) 221-1263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2331 York Rd
Suite 100
Timonium, MD 21093-2225

9 Fountain Dr
Stafford, VA 22554-7298

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701008963VAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1154940617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 FOUNTAIN DR",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225547298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 FOUNTAIN DR",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225547298",
            "telephone_number": "571-206-8078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13000 Harbor Center Dr Ste 362",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "VA",
            "postal_code": "221922846",
            "country_code": "US",
            "telephone_number": "703-221-1263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARTER",
        "first_name": "TAMARA",
        "middle_name": "LA SHAUN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-14",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701008963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

Verify at the official NPI Registry.