Active NPI
Jack Carter Sykstus, LMFT
- Marriage & Family Therapist
- Alexandria, VA
National Provider Identifier
1235714437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 0717001799
- Practice address
- 1900 Mount Vernon Ave
Alexandria, VA 22301-1302 - Phone
- (202) 960-4193
- NPI assigned
- Mar 10, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 0717001799 | VA | Primary |
Addresses
Primary practice location
1900 Mount Vernon Ave
Alexandria, VA 22301-1302
Mailing address
817 L St NE
Washington, DC 20002-3640
Phone (256) 690-8024
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 |
|---|---|---|---|
| 0717001799 | VA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615334400000",
"number": "1235714437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "817 L ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200023640",
"telephone_number": "256-690-8024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 MOUNT VERNON AVE",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223011302",
"telephone_number": "202-960-4193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYKSTUS",
"first_name": "JACK",
"middle_name": "CARTER",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-10",
"last_updated": "2021-03-10",
"certification_date": "2021-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "VA",
"license": "0717001799",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.