Jose L Diaz

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701007329 Issued in VA

Practice address

3700 Joseph Siewick Dr Ste 408a
Fairfax, VA 22033-1745

Phone

(703) 391-3300

Fax

(703) 391-4380

NPI assigned

Oct 18, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Revive and Thrive Counseling, PLLC

  • Mental Health Counselor
  • Reston, VA
  • NPI 1366325466

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1316257983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 JOSEPH SIEWICK DR STE 408A",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331745",
            "telephone_number": "703-391-3300",
            "fax_number": "703-391-4380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 JOSEPH SIEWICK DR STE 408A",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331745",
            "telephone_number": "703-391-3300",
            "fax_number": "703-391-4380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9600 SW 8th St",
            "address_2": "STE#1",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331742900",
            "country_code": "US",
            "telephone_number": "305-559-8838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "JOSE",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-18",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 10445",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701007329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elise R Diamond, M.D., M.P.H
• Zelda Jacqueline Diamond
• Carolina Beatriz Diaz
• Diana Marcela Diaz, LCSW
• Elizabeth Diaz, LPC, LMHC, NCC
• Sarah Diaz
• Yesenia Diaz
• Kourosh Dibadj, M.D.
• Samantha Leigh Dibenedetto, MD
• Barry S Dicicco, M.D.

• All providers in Fairfax, VA
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.

Verify at the official NPI Registry.