Marianne G Shirilla, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

0717001260 Issued in VA

Practice address

10379 B Democracy Lane
Fairfax, VA 22030-2505

Phone

(703) 657-9721

Fax

(703) 591-2563

NPI assigned

Jan 11, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 17, 2024 through Mar 17, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Synergy Counseling, LLC

  • Marriage & Family Therapist
  • Fairfax, VA
  • NPI 1336613439
  NPD

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628294400000",
    "number": "1760712954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10379 B DEMOCRACY LANE",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302505",
            "telephone_number": "703-657-9721",
            "fax_number": "703-591-2563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10379 B DEMOCRACY LANE",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302505",
            "telephone_number": "703-657-9721",
            "fax_number": "703-591-2563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRILLA",
        "first_name": "MARIANNE",
        "middle_name": "G",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-11",
        "last_updated": "2021-08-07",
        "certification_date": "2021-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717001260",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701004270",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104429",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia Shin
• Jacquelynne Kristeen Shinault, BCBA, LBA
• Tracy Shiplett, PT
• Jonelle Craig Shipley, MS CCC-SLP
• Swati Sudheer Shirali, MD
• Barry Michael Shmookler, MD
• Eugene A Shmorhun, MD
• Khadijat Morenike Ibukun Shodeinde
• Elizabeth Shoemaker
• Myron Alan Shoham, M.D.

• Marriage & Family Therapist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Marriage & Family Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.