Active NPI
Daniel Lavelle
- Mental Health Counselor
- Vienna, VA
National Provider Identifier
1710503362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0701012726
- Practice address
- 501 Church St NE Ste 212
Vienna, VA 22180-4734 - Phone
- (571) 358-9765
- NPI assigned
- Jun 19, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0701012726 | VA | Primary |
Addresses
Primary practice location
501 Church St NE Ste 212
Vienna, VA 22180-4734
Mailing address
11730 Indian Ridge Rd
Reston, VA 20191-3522
Phone (571) 230-4205
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701012726 | VA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elevated Mindset Therapy, LLC | Mental Health | Current | Accepting new patients |
Locations
501 Church St NE
Ste 212
Vienna, VA 22180
Phone (571) 358-9765
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 and National Provider Directory roles.
-
- Mental Health Counselor
- Vienna, VA
- NPI 1558296335
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716163200000",
"number": "1710503362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11730 INDIAN RIDGE RD",
"city": "RESTON",
"state": "VA",
"postal_code": "201913522",
"telephone_number": "571-230-4205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 CHURCH ST NE STE 212",
"city": "VIENNA",
"state": "VA",
"postal_code": "221804734",
"telephone_number": "571-358-9765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVELLE",
"first_name": "DANIEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-19",
"last_updated": "2024-05-20",
"certification_date": "2024-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VA",
"license": "0701012726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vienna, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.