Individual provider Active NPI

Ashraf Sefain, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fairfax, VA
National Provider Identifier
1689211054
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024189284 Issued in VA
Practice address
10521 Rosehaven St Ste 100
Fairfax, VA 22030-2877
Phone
(703) 650-0636
NPI assigned
Dec 4, 2019
Last updated
Jan 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024189284 VA Primary

Addresses

Primary practice location

10521 Rosehaven St Ste 100
Fairfax, VA 22030-2877

Mailing address

10521 Rosehaven St Ste 100
Fairfax, VA 22030-2877
Phone (703) 650-0636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250219001041 VA Practitioner - Nurse Practitioner 8123548385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Commonwealth Counseling Associates IncGroup PAC ID 0941288583, 207 clinicians

Practice addresses (Care Compare)

7051 Heathcote Village Way
Suite 115
Gainesville, VA 20155-3197
Phone (804) 207-6737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024189284VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Counseling Associates Inc Psychiatric/Mental Health CurrentSince Nov 9, 2024 Accepting new patients

Locations

7051 Heathcote Village Way
Ste 115
Gainesville, VA 20155
Phone (571) 918-9239

9202 Center Oak Ct
Mechanicsvlle, VA 23116
Phone (804) 639-1112

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.ashrafsefain@144557.advancedmd-direct.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1689211054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10521 ROSEHAVEN ST STE 100",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302877",
            "telephone_number": "703-650-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10521 ROSEHAVEN ST STE 100",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302877",
            "telephone_number": "703-650-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEFAIN",
        "first_name": "ASHRAF",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-04",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024189284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.