Organization Active NPI

County of Loudoun, Virginia

Doing business as Loudoun County Community Services Board

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Leesburg, VA
National Provider Identifier
1386753291
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
143 Issued in VA
Legal business name
COUNTY OF LOUDOUN, VIRGINIA
Doing business as
Loudoun County Community Services Board
Practice address
102 Heritage Way NE
Suite 310
Leesburg, VA 20176-4544
Phone
(703) 737-8677
Fax
(703) 737-8676
NPI assigned
Aug 30, 2006
Last updated
Jan 26, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTY OF LOUDOUN, VIRGINIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

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

Authorized official

Name
Ms. Margaret Graham
Title
Agency Director
Phone
(703) 771-5406

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 143 VA
Developmentally Disabled Services Day Training Agency 251C00000X 143 VA
Community/Behavioral Health Agency 251S00000X 143 VA
Early Intervention Provider Agency 252Y00000X 143 VA
Developmental Disabilities Clinic/Center 261QD1600X 143 VA
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 143 VA Primary
Rehabilitation Clinic/Center 261QR0400X 143 VA
Mental Illness Intermediate Care Facility 310500000X 143 VA
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 143 VA
Mental Illness Community Based Residential Treatment Facility 320800000X 143 VA
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X 143 VA

Addresses

Primary practice location

102 Heritage Way NE
Suite 310
Leesburg, VA 20176-4544

Mailing address

906 Trailview Blvd SE
Suite C
Leesburg, VA 20175-4415
Phone (703) 737-8677

Other identifiers 7

IdentifierTypeStateIssuer
004945140MedicaidVA
187217OtherVAANTHEM SLP
LCCBOtherVAAMERIGROUP - VIRGINIA
004980433MedicaidVA
187219OtherVAANTHEM OT
187220OtherVAANTHEM PT
008743673MedicaidVA

Other names 1

  • Loudoun County Community Services Board Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040528000959 VA Part B Supplier - Clinic/Group Practice 8426039959 Receives reassigned benefits from 52 practitioners
1 other NPI on this enrollment
Practice locations: Ashburn, VA; Leesburg, VA; Sterling, VA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
County of Loudoun Virginia4 organizations share this tax ID, including this one
Part of
County of Loudoun Virginia

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

102 Heritage Way NE
Ste 310
Leesburg, VA 20176
Phone (703) 737-8677

906 Trailview Blvd SE
Leesburg, VA 20175
Phone (703) 727-1640

21641 Ridgetop Cir
Ste 210
Sterling, VA 20166
Phone (571) 420-2202

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 73

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 73

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485388800000",
    "number": "1386753291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 TRAILVIEW BLVD SE",
            "address_2": "SUITE C",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201754415",
            "telephone_number": "703-737-8677",
            "fax_number": "703-737-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HERITAGE WAY NE",
            "address_2": "SUITE 310",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201764544",
            "telephone_number": "703-737-8677",
            "fax_number": "703-737-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF LOUDOUN, VIRGINIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF LOUDOUN, VIRGINIA",
        "enumeration_date": "2006-08-30",
        "last_updated": "2017-01-26",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "AGENCY DIRECTOR",
        "authorized_official_telephone_number": "703-771-5406",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "VA",
            "license": "143",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "VA",
            "license": "143",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "143",
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "VA",
            "license": "143",
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "VA",
            "license": "143",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "VA",
            "license": "143",
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "VA",
            "license": "143",
            "primary": false
        },
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "VA",
            "license": "143",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "143",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "VA",
            "license": "143",
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "VA",
            "license": "143",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945140",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM SLP",
            "identifier": "187217",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP - VIRGINIA",
            "identifier": "LCCB",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004980433",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM OT",
            "identifier": "187219",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PT",
            "identifier": "187220",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008743673",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Loudoun County Community Services Board",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.