Individual provider Active NPI

Holly Victoria Gilbo de Serrano

  • Professional Counselor
  • Reston, VA
National Provider Identifier
1679201594
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
11733 Bowman Green Dr Ste 100
Reston, VA 20190-3501
Phone
(571) 308-9605
NPI assigned
Aug 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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 Primary

Addresses

Primary practice location

11733 Bowman Green Dr Ste 100
Reston, VA 20190-3501

Mailing address

11733 Bowman Green Dr Ste 100
Reston, VA 20190-3501
Phone (571) 308-9605

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

NPI Registry JSON

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1679201594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11733 BOWMAN GREEN DR STE 100",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903501",
            "telephone_number": "571-308-9605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11733 BOWMAN GREEN DR STE 100",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903501",
            "telephone_number": "571-308-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBO DE SERRANO",
        "first_name": "HOLLY",
        "middle_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-09",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "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 Oct 12, 2022; 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.