Active NPI
Brenton Sanford
- Professional Counselor
- Alexandria, VA
National Provider Identifier
1447960448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0704017739
- Practice address
- 3014 Colvin St Ste 1-a
Alexandria, VA 22314-5031 - Phone
- (703) 936-6214
- NPI assigned
- Nov 30, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | 0704017739 | VA | Primary |
Addresses
Primary practice location
3014 Colvin St Ste 1-a
Alexandria, VA 22314-5031
Mailing address
3014 Colvin St Ste 1-a
Alexandria, VA 22314-5031
Phone (703) 936-6214
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 |
|---|---|---|---|
| 0704017739 | VA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738195200000",
"number": "1447960448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3014 COLVIN ST STE 1-A",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223145031",
"telephone_number": "703-936-6214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3014 COLVIN ST STE 1-A",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223145031",
"telephone_number": "703-936-6214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANFORD",
"first_name": "BRENTON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-11-30",
"last_updated": "2025-01-30",
"certification_date": "2025-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0704017739",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.