Active NPI
Elizabeth Autrey-Moore
- Mental Health Counselor
- Falls Church, VA
National Provider Identifier
1265055933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0704013215
- Practice address
- 124 E Broad St Ste D
Falls Church, VA 22046-4530 - Phone
- (703) 534-5100
- NPI assigned
- May 28, 2020
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0704013215 | VA | Primary |
Addresses
Primary practice location
124 E Broad St Ste D
Falls Church, VA 22046-4530
Mailing address
124 E Broad St Ste D
Falls Church, VA 22046-4530
Phone (571) 453-7225
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 |
|---|---|---|---|
| 0704013215 | VA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunstone Counseling, PLLC | Mental Health | Past | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590624000000",
"number": "1265055933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 E BROAD ST STE D",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220464530",
"telephone_number": "571-453-7225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 E BROAD ST STE D",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220464530",
"telephone_number": "703-534-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUTREY-MOORE",
"first_name": "ELIZABETH",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-28",
"last_updated": "2020-05-28",
"certification_date": "2020-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VA",
"license": "0704013215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Falls Church, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.