Individual provider Active NPI

Terry Absalom

  • Mental Health Counselor
  • Leesburg, VA
National Provider Identifier
1720776388
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
102 Heritage Way NE Ste 102
Leesburg, VA 20176-4544
Phone
(703) 777-0320
NPI assigned
May 1, 2023
Last updated
May 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

102 Heritage Way NE Ste 102
Leesburg, VA 20176-4544

Mailing address

102 Heritage Way NE Ste 102
Leesburg, VA 20176-4544

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260401002208 VA Practitioner - Clinical Social Worker 6103301627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

906 A Trailview Blvd SE
Leesburg, VA 20175-4415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Loudoun, Virginia PastSince Feb 4, 2026 Accepting new patients
County of Loudoun, Virginia PastSince Feb 4, 2026 Accepting new patients

Organizations & group practices 2

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": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1720776388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HERITAGE WAY NE STE 102",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201764544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HERITAGE WAY NE STE 102",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201764544",
            "telephone_number": "703-777-0320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABSALOM",
        "first_name": "TERRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.