Active NPI
Susannah Volkers
- Counselor
- Fairfax, VA
National Provider Identifier
1205480050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 0704013263
- Practice address
- 10379B Democracy LN
Fairfax, VA 22030-2505 - Phone
- (703) 591-2551
- NPI assigned
- Jul 30, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 0704013263 | VA | Primary |
Addresses
Primary practice location
10379B Democracy LN
Fairfax, VA 22030-2505
Mailing address
10379B Democracy LN
Fairfax, VA 22030-2505
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 18, 2024 through Apr 18, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0704013263 | VA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Restoring Eden Counseling, LLC | Current | Accepting new patients |
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.
-
dba Restoring Eden
- Professional Counselor
- Alexandria, VA
- NPI 1205697927
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618012800000",
"number": "1205480050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10379B DEMOCRACY LN",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220302505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10379B DEMOCRACY LN",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220302505",
"telephone_number": "703-591-2551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VOLKERS",
"first_name": "SUSANNAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-30",
"last_updated": "2021-04-10",
"certification_date": "2021-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "VA",
"license": "0704013263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.