Individual provider Active NPI

Samuel Woldeghebriel Seium, LPC

  • Professional Counselor
  • Manassas, VA
National Provider Identifier
1346863214
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701008848 Issued in VA
Practice address
7969 Ashton Ave
Manassas, VA 20109-2885
Phone
(703) 792-7800
NPI assigned
May 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701008848 VA Primary

Addresses

Primary practice location

7969 Ashton Ave
Manassas, VA 20109-2885

Mailing address

7969 Ashton Ave
Manassas, VA 20109-2885
Phone (703) 792-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231228000148 VA Practitioner - Mental Health Counselor 0244680668 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701008848VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Prince William County CurrentSince Jan 1, 2024 Accepting new patients
Prince William County Community Services Board CurrentSince Jan 1, 2024 Accepting new patients

Locations

7969 Ashton Ave
Manassas, VA 20109
Phone (703) 792-7826

14011 Worth Ave
Ste 110
Woodbridge, VA 22192

Organizations & group practices 2

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": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1346863214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7969 ASHTON AVE",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092885",
            "telephone_number": "703-792-7800",
            "fax_number": "703-792-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7969 ASHTON AVE",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092885",
            "telephone_number": "703-792-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIUM",
        "first_name": "SAMUEL",
        "middle_name": "WOLDEGHEBRIEL",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701008848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.