Individual provider Active NPI

Rebecca Milloy Mello, LCSW

  • Clinical Social Worker
  • Reston, VA
National Provider Identifier
1528573243
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904010174 Issued in VA
Practice address
1850 Cameron Glen Dr Ste 600
Reston, VA 20190-3343
Phone
(703) 481-4144
NPI assigned
Dec 4, 2017
Last updated
Apr 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904010174 VA Primary

Addresses

Primary practice location

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

Mailing address

1850 Cameron Glen Dr Ste 600
Reston, VA 20190-3343
Phone (703) 481-4100

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904010174VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1528573243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 CAMERON GLEN DR STE 600",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903343",
            "telephone_number": "703-481-4100",
            "fax_number": "703-435-1961"
        },
        {
            "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": "703-481-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLO",
        "first_name": "REBECCA",
        "middle_name": "MILLOY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-04",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.