Active NPI
Shadi Kamrani George, M.A., LPC
- Professional Counselor
- Fairfax, VA
National Provider Identifier
1376865451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701004751
- Practice address
- 11204 Waples Mill Rd
Fairfax, VA 22030-6036 - Phone
- (703) 218-8506
- Fax
- (703) 359-0463
- NPI assigned
- Feb 17, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701004751 | VA | Primary |
Addresses
Primary practice location
11204 Waples Mill Rd
Fairfax, VA 22030-6036
Mailing address
PO Box 1110
Fairfax, VA 22038-1110
Phone (703) 218-8506
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4943902 | Medicaid | VA |
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701004751 | VA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266364800000",
"number": "1376865451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1110",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220381110",
"telephone_number": "703-218-8506",
"fax_number": "703-359-0463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11204 WAPLES MILL RD",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220306036",
"telephone_number": "703-218-8506",
"fax_number": "703-359-0463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEORGE",
"first_name": "SHADI",
"middle_name": "KAMRANI",
"credential": "M.A., LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-17",
"last_updated": "2010-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701004751",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4943902",
"state": "VA"
}
],
"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 Feb 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.