Active NPI
Gloria Quevedo, MA, LPC
- Mental Health Counselor
- Arlington, VA
National Provider Identifier
1336105279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0701002903
- Practice address
- 3801 Fairfax Dr
53
Arlington, VA 22203-1762 - Phone
- (202) 641-5329
- Fax
- (202) 526-0110
- NPI assigned
- Apr 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 0701002903 | VA | Primary |
Addresses
Primary practice location
3801 Fairfax Dr
53
Arlington, VA 22203-1762
Mailing address
3801 Fairfax Dr
53
Arlington, VA 22203-1762
Phone (202) 641-5329
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7293273 | Other | VA | AETNA BEHAVIORAL |
| 509867669 | Other | VA | UBH |
| 89130013 | Other | VA | CAREFIRST BCBS |
| 005408482 | Medicaid | VA | |
| 385442 | Other | VA | ANTHEM |
| 293620 | Other | VA | MAMSI |
| 264926000 | Other | VA | MAGELLAN |
| 541598045 | Other | VA | NCPPO |
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 17, 2024 through Jan 17, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701002903 | VA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311897600000",
"number": "1336105279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3801 FAIRFAX DR",
"address_2": "53",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "222031762",
"telephone_number": "202-641-5329",
"fax_number": "202-526-0110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 FAIRFAX DR",
"address_2": "53",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "222031762",
"telephone_number": "202-641-5329",
"fax_number": "202-526-0110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUEVEDO",
"first_name": "GLORIA",
"credential": "MA, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-20",
"last_updated": "2011-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VA",
"license": "0701002903",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA BEHAVIORAL",
"identifier": "7293273",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH",
"identifier": "509867669",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BCBS",
"identifier": "89130013",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005408482",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "385442",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "293620",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "264926000",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPPO",
"identifier": "541598045",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arlington, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; 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.