Abdelwahab Eltayeb Elsirag

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

12587 Fair Lakes Cir Ste 303
Fairfax, VA 22033-3822

Phone

(703) 309-8733

NPI assigned

Feb 1, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1487119707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12587 FAIR LAKES CIR STE 303",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333822",
            "telephone_number": "703-309-8733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12587 FAIR LAKES CIR STE 303",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333822",
            "telephone_number": "703-309-8733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSIRAG",
        "first_name": "ABDELWAHAB",
        "middle_name": "ELTAYEB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-01",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lila Elliott
• Mariah Katelyn Elliott
• Kathleen Ellison, M.D.
• Oscar Ellison III, MD
• Elmotasembellah Elnaggar
• Amelia Ely, DPT
• Lindsey Emami, M.S., CCC-SLP
• Abbas Emaminia, MD
• Emergency Medicine Associates P.a., P.C.
• Emergency Surgery, LLC

• Mental Health Counselor in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.