Individual provider Active NPI

Susanne Gwynn Oshry, LPC

  • Counseling Psychologist
  • Burke, VA
National Provider Identifier
1356433502
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
0701003063 Issued in VA
Practice address
5205 Lyngate CT Ste a
Burke, VA 22015-1693
Phone
(571) 233-2135
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 0701003063 VA Primary

Addresses

Primary practice location

5205 Lyngate CT Ste a
Burke, VA 22015-1693

Mailing address

5205-A Lyngate Court
Burke, VA 22015-2428
Phone (571) 233-2135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20240320001101 DC Practitioner - Mental Health Counselor 7012354533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5205 Lyngate CT
Suite a
Burke, VA 22015-1693
Phone (571) 233-2135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701003063VAMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling and Training SRVS LLC CurrentSince Jan 10, 2024 Accepting new patients

Locations

5205 Lyngate Ct
Ste A
Burke, VA 22015
Phone (571) 233-2135

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1356433502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205-A LYNGATE COURT",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220152428",
            "telephone_number": "571-233-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 LYNGATE CT STE A",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220151693",
            "telephone_number": "571-233-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSHRY",
        "first_name": "SUSANNE",
        "middle_name": "GWYNN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "VA",
            "license": "0701003063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burke, VA

Sources for this page

Verify at the official NPI Registry.