Mary S Zimomra, LPC, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

0717000883 Issued in VA

Practice address

12007 Sunrise Valley Dr Ste 300
Reston, VA 20191-3446

Phone

(804) 207-6737

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mary Suzette Zimomra Other name

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

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 2

Specialty

Marriage and Family Therapist

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Commonwealth Counseling Associates IncGroup PAC ID 0941288583, 207 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: granatogroup.maryzimomra@144557.advancedmd-direct.com

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.

• Commonwealth Counseling Associates Inc

  • Clinical Psychologist
  • Mechanicsville, VA
  • NPI 1851345805

  DC, Professional

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1780770537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12007 SUNRISE VALLEY DR STE 300",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913446",
            "telephone_number": "804-207-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12007 SUNRISE VALLEY DR STE 300",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913446",
            "telephone_number": "804-207-6737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1360 Beverly Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Mc Lean",
            "state": "VA",
            "postal_code": "221013647",
            "country_code": "US",
            "telephone_number": "804-207-6737",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7051 Heathcote Village Way Ste 115",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "VA",
            "postal_code": "201553197",
            "country_code": "US",
            "telephone_number": "804-207-6737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMOMRA",
        "first_name": "MARY",
        "middle_name": "S",
        "credential": "LPC, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701001964",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717000883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30015390670007",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "ZIMOMRA",
            "middle_name": "SUZETTE",
            "credential": "LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Hongyan Zhang
• Lijuan Zhang, LMT
• Ming Zhang, MD
• Diane D Zhao, MD
• Martha F Zier, CRNP
• Letha B Zook, PT
• Amanda Zuidema, PLPC
• Arnela Zukanovic

• Marriage & Family Therapist in Reston, VA
• Providers in Reston, 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 Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.