Individual provider Active NPI

Edward Lee Hendrickson, LMFT, LSATP

  • Mental Health Counselor
  • Alexandria, VA
National Provider Identifier
1285799874
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0717000337 Issued in VA
Practice address
5249 Duke St
Suite 200
Alexandria, VA 22304-2926
Phone
(703) 823-3972
NPI assigned
Dec 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0718000093 VA
Mental Health Counselor 101YM0800X 0717000337 VA Primary

Addresses

Primary practice location

5249 Duke St
Suite 200
Alexandria, VA 22304-2926

Mailing address

1109 N Howard St
Alexandria, VA 22304-1627
Phone (703) 823-9617

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 9, 2024 through Jan 9, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0718000093VAMDAddiction (Substance Use Disorder) Counselor
0717000337VAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1285799874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 N HOWARD ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041627",
            "telephone_number": "703-823-9617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5249 DUKE ST",
            "address_2": "SUITE 200",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223042926",
            "telephone_number": "703-823-3972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "EDWARD",
        "middle_name": "LEE",
        "credential": "LMFT, LSATP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0718000093",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0717000337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.