Emerald Leaf Counseling LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

EMERALD LEAF COUNSELING LLC

Practice address

5275 Lee Hwy Ste 104
Arlington, VA 22207-1619

Phone

(703) 829-6350

NPI assigned

Jun 26, 2019

Organization subpart

No

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

Authorized official

Name

Miki Goerdt, LCSWNPI 1558784520

Title

Owner

Phone

(703) 829-6350

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Miki Nishida Goerdt

  • Mental Health Counselor
  • Falls Church, VA
  • NPI 1558784520

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568851200000",
    "number": "1518528959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2916 LAWRENCE DR",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220421405",
            "telephone_number": "703-829-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5275 LEE HWY STE 104",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222071619",
            "telephone_number": "703-829-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD LEAF COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-26",
        "last_updated": "2019-09-19",
        "status": "A",
        "authorized_official_last_name": "GOERDT",
        "authorized_official_first_name": "MIKI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-829-6350",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Arlington, VA
• Providers in Arlington, VA by specialty
• Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.