Individual provider Active NPI

Satsatnam K. Khalsa, MS, CSAC, LSATP

  • Addiction (Substance Use Disorder) Counselor
  • Reston, VA
National Provider Identifier
1376724104
Registry record updated Nov 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
0718000186 Issued in VA
Practice address
11975 Bowman Towne Dr
Reston, VA 20190-3306
Phone
(571) 323-1392
Fax
(703) 437-7315
NPI assigned
Nov 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0718000186 VA Primary

Addresses

Primary practice location

11975 Bowman Towne Dr
Reston, VA 20190-3306

Mailing address

11975 Bowman Towne Dr
Reston, VA 20190-3306
Phone (571) 323-1392

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0718000186VAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195516800000",
    "number": "1376724104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11975 BOWMAN TOWNE DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903306",
            "telephone_number": "571-323-1392",
            "fax_number": "703-437-7315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11975 BOWMAN TOWNE DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903306",
            "telephone_number": "571-323-1392",
            "fax_number": "703-437-7315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALSA",
        "first_name": "SATSATNAM",
        "middle_name": "K.",
        "name_prefix": "Ms.",
        "credential": "MS, CSAC, LSATP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-20",
        "last_updated": "2007-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0718000186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; 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.