Individual provider Active NPI

Mary Linda Sara, PH.D

  • Professional Counselor
  • Reston, VA
National Provider Identifier
1720398936
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701-001044 Issued in VA
Practice address
11367 Sunset Hills Rd
Reston, VA 20190-5205
Phone
(703) 437-6890
Fax
(703) 437-6872
NPI assigned
Oct 21, 2010
Last updated
Oct 21, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701-001044 VA Primary
Marriage & Family Therapist 106H00000X 0717-000804 VA

Addresses

Primary practice location

11367 Sunset Hills Rd
Reston, VA 20190-5205

Mailing address

11367 Sunset Hills Rd
Reston, VA 20190-5205
Phone (703) 437-6890

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0701-001044VAMDProfessional Counselor
0717-000804VAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1720398936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11367 SUNSET HILLS RD",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905205",
            "telephone_number": "703-437-6890",
            "fax_number": "703-437-6872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11367 SUNSET HILLS RD",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905205",
            "telephone_number": "703-437-6890",
            "fax_number": "703-437-6872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARA",
        "first_name": "MARY LINDA",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-21",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701-001044",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717-000804",
            "primary": false
        }
    ],
    "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 21, 2010; 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.