Active NPI
Northern Virginia Older Adult Counseling
- Community/Behavioral Health Agency
- Fairfax, VA
National Provider Identifier
1831569896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 0904006279
- Legal business name
- NORTHERN VIRGINIA OLDER ADULT COUNSELING
- Practice address
- 4700 Banting CT
Fairfax, VA 22032-2451 - Phone
- (703) 424-0410
- NPI assigned
- Oct 3, 2015
- Last updated
- Feb 4, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan M Johnson
- Title
- Partner/Operations Officer
- Phone
- (703) 424-0410
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 0904006279 | VA | Primary |
Addresses
Primary practice location
4700 Banting CT
Fairfax, VA 22032-2451
Mailing address
4700 Banting CT
Fairfax, VA 22032-2451
Phone (703) 424-0410
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
10615 Judicial Dr
Ste 301
Fairfax, VA 22030
Phone (703) 424-0410
Practitioners & affiliated clinicians
Practitioners 30
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443830400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1454544000000",
"number": "1831569896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 BANTING CT",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220322451",
"telephone_number": "703-424-0410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 BANTING CT",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220322451",
"telephone_number": "703-424-0410"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHERN VIRGINIA OLDER ADULT COUNSELING",
"organizational_subpart": "NO",
"enumeration_date": "2015-10-03",
"last_updated": "2016-02-04",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PARTNER/OPERATIONS OFFICER",
"authorized_official_telephone_number": "703-424-0410"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "VA",
"license": "0904006279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
- Northern Virginia Hand and Nerve
- Northern Virginia Healthcare, P.C
- Northern Virginia Instructional Consulting, LLC
- Northern Virginia Nephrology Associates PC
- Northern Virginia OBGYN Associates, LTD.
- Northern Virginia Oncology Group, P.C.
- Northern Virginia Oral and Facial Surgery, LLC (Northern Virginia Center for Oral, Facial and Implant Surgery)
- Northern Virginia Pathology PC
- Northern Virginia Pediatric Orthopaedics PLLC
- Northern Virginia Pelvic Surgery Associates, PC (Mid Atlantic Gynecologic Oncology and Pelvic Surgery Asso)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.