Active NPI
Freddie Nolen, LPC
- Professional Counselor
- Vienna, VA
National Provider Identifier
1376879833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701004513
- Practice address
- 133 Park St NE
Vienna, VA 22180-4602 - Phone
- (703) 281-4928
- Fax
- (703) 242-1454
- NPI assigned
- Oct 19, 2009
- Sex
- Male
- 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 | 0701004513 | VA | Primary |
Addresses
Primary practice location
133 Park St NE
Vienna, VA 22180-4602
Mailing address
133 Park St NE
Vienna, VA 22180-4602
Phone (703) 281-4928
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701004513 | VA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Womens Center | Professional | Past | Accepting new patients |
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": "1255910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361491200000",
"number": "1376879833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 PARK ST NE",
"city": "VIENNA",
"state": "VA",
"postal_code": "221804602",
"telephone_number": "703-281-4928",
"fax_number": "703-242-1454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 PARK ST NE",
"city": "VIENNA",
"state": "VA",
"postal_code": "221804602",
"telephone_number": "703-281-4928",
"fax_number": "703-242-1454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLEN",
"first_name": "FREDDIE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-10-19",
"last_updated": "2013-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701004513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vienna, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.