Individual provider Active NPI

Emma Lauryn Hildreth

  • Mental Health Counselor
  • Fairfax, VA
National Provider Identifier
1366251001
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3915 Blenheim Blvd Ste 23a
Fairfax, VA 22030-2432
Phone
(703) 259-5617
NPI assigned
Jan 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

3915 Blenheim Blvd Ste 23a
Fairfax, VA 22030-2432

Mailing address

12328 Iona Sound Dr
Bristow, VA 20136-1920
Phone (571) 428-7349

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1736208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1366251001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12328 IONA SOUND DR",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201361920",
            "telephone_number": "571-428-7349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 BLENHEIM BLVD STE 23A",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302432",
            "telephone_number": "703-259-5617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILDRETH",
        "first_name": "EMMA",
        "middle_name": "LAURYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.