Active NPI
Theresa Marie George, LPC
- Addiction (Substance Use Disorder) Counselor
- Leesburg, VA
National Provider Identifier
1760592612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 0701003264
- Practice address
- 102 Heritage Way NE
Suite 302
Leesburg, VA 20176-4544 - Phone
- (703) 771-5163
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 0701003264 | VA | Primary |
| Mental Health Counselor | 101YM0800X | 0701003264 | VA |
Addresses
Primary practice location
102 Heritage Way NE
Suite 302
Leesburg, VA 20176-4544
Mailing address
102 Heritage Way NE
Suite 302
Leesburg, VA 20176-4544
Phone (703) 771-5163
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 385153 | Other | VA | ANTHEM |
| 540948306 | Other | VA | TRICARE |
| 293870 | Other | VA | AMERIGROUP |
Other names 1
- Terri George
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 |
|---|---|---|---|
| 0701003264 | VA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364428800000",
"number": "1760592612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 HERITAGE WAY NE",
"address_2": "SUITE 302",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201764544",
"telephone_number": "703-771-5163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 HERITAGE WAY NE",
"address_2": "SUITE 302",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201764544",
"telephone_number": "703-771-5163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEORGE",
"first_name": "THERESA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2013-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "VA",
"license": "0701003264",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VA",
"license": "0701003264",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "385153",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "540948306",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "293870",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TERRI",
"last_name": "GEORGE",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Leesburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.