Individual provider Active NPI

Kayran Treia Lee

  • Professional Counselor
  • Fairfax Station, VA
National Provider Identifier
1427781491
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701011188 Issued in VA
Practice address
10416 Burke Lake Rd
Fairfax Station, VA 22039-1808
Phone
(703) 297-8416
NPI assigned
Jul 6, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701011188 VA Primary

Addresses

Primary practice location

10416 Burke Lake Rd
Fairfax Station, VA 22039-1808

Mailing address

500 Abberly Dr Apt 302
Stafford, VA 22554-7346
Phone (570) 994-4645

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240313001820 VA Practitioner - Mental Health Counselor 8224474242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Youth for Tomorrow New Life Center IncGroup PAC ID 1951673227, 15 clinicians

Practice addresses (Care Compare)

14000 Crown CT
Suite 101
Woodbridge, VA 22193-1461
Phone (703) 659-9900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701011188VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Youth for Tomorrow New Life Center, Inc. Professional CurrentSince Jan 29, 2024 Accepting new patients

Locations

11835 Hazel Circle Dr
Bristow, VA 20136
Phone (703) 368-7995

3800 Fettler Park Dr
Ste 103
Dumfries, VA 22025

14000 Crown Ct
Ste 101
Woodbridge, VA 22193
Phone (703) 659-9900

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": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1427781491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ABBERLY DR APT 302",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225547346",
            "telephone_number": "570-994-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10416 BURKE LAKE RD",
            "city": "FAIRFAX STATION",
            "state": "VA",
            "postal_code": "220391808",
            "telephone_number": "703-297-8416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KAYRAN",
        "middle_name": "TREIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701011188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax Station, VA

Sources for this page

Verify at the official NPI Registry.