Individual provider Active NPI

Samira Milanizadeh, LPC

  • Professional Counselor
  • Manassas, VA
National Provider Identifier
1811417843
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701007167 Issued in VA
Practice address
8100 Ashton Ave Ste 101
Manassas, VA 20109-5647
Phone
(571) 665-6550
Fax
(571) 665-6551
NPI assigned
Jun 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701007167 VA Primary

Addresses

Primary practice location

8100 Ashton Ave Ste 101
Manassas, VA 20109-5647

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5699

Electronic endpoints 2

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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

Enrollment IDStateProvider typePAC IDDetails
I20240511000051 DC Practitioner - Mental Health Counselor 6608217450 Reassigns benefits to 1 organization
I20250313002070 VA Practitioner - Mental Health Counselor 6608217450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

1005 N Glebe Rd
Arlington, VA 22201-5758

3650 Joseph Siewick Dr
Suite 110
Fairfax, VA 22033-1711
Phone (703) 620-3211

8100 Ashton Ave
Suite 101
Manassas, VA 20109-5647
Phone (703) 205-7330

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031-4512
Phone (703) 289-7560

8505 Arlington Blvd
Fairfax, VA 22031-4630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Feb 27, 2024 Accepting new patients
Inova Health Care Services CurrentSince Feb 27, 2024 Accepting new patients

Locations

8505 Arlington Blvd
Ste 200
Fairfax, VA 22031
Phone (703) 698-8525

8095 Innovation Park Dr
Bldg C
Fairfax, VA 22031
Phone (571) 472-6253

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031
Phone (703) 289-7599

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

8100 Ashton Ave
Ste 101
Sudley Springs, VA 20109
Phone (703) 205-7330

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1811417843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 ASHTON AVE STE 101",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201095647",
            "telephone_number": "571-665-6550",
            "fax_number": "571-665-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILANIZADEH",
        "first_name": "SAMIRA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701007167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8221 Willow Oaks Corporate Dr",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220314512",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8221 Willow Oaks Corporate Dr",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220314512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.