Individual provider Active NPI

Lakeisha Grayer, LPC

  • Professional Counselor
  • Reston, VA
National Provider Identifier
1467077651
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701009286 Issued in VA
Practice address
1850 Cameron Glen Dr Ste 600
Reston, VA 20190-3343
Phone
(571) 595-9013
NPI assigned
Jun 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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 0701009286 VA Primary

Addresses

Primary practice location

1850 Cameron Glen Dr Ste 600
Reston, VA 20190-3343

Mailing address

3033 Wilson Blvd Ste 700
Arlington, VA 22201-3868
Phone (757) 303-7808

Other practice location 1

3033 Wilson Blvd Ste 700
Arlington, VA 22201-3868
Phone (757) 303-7808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20240125000366 DC Practitioner - Mental Health Counselor 9133572241 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax County, Virginia CurrentSince Jan 1, 2024 Accepting new patients
Thrive Counseling LLC PastSince Jun 1, 2020 Accepting new patients

Locations

12011 Government Center Pkwy
Ste 836
Fairfax, VA 22035
Phone (703) 324-7017

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031
Phone (703) 289-7599

1850 Cameron Glen Dr
Ste 600
Reston, VA 20190
Phone (703) 481-4100

Organizations & group practices 2

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": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1467077651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 WILSON BLVD STE 700",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222013868",
            "telephone_number": "757-303-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 CAMERON GLEN DR STE 600",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903343",
            "telephone_number": "571-595-9013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3033 Wilson Blvd Ste 700",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222013868",
            "country_code": "US",
            "telephone_number": "757-303-7808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAYER",
        "first_name": "LAKEISHA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-12",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701009286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.