Individual provider Active NPI

Malvolia La Frances Gregory, LPC (IN TRAINING)

  • Professional Counselor
  • Fairfax, VA
National Provider Identifier
1851551311
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
11230 Waples Mill Rd
Suite 105
Fairfax, VA 22030-6087
Phone
(703) 208-1500
Fax
(703) 208-1540
NPI assigned
Jun 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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 Primary

Addresses

Primary practice location

11230 Waples Mill Rd
Suite 105
Fairfax, VA 22030-6087

Mailing address

11230 Waples Mill Rd
Suite 105
Fairfax, VA 22030-6087
Phone (703) 208-1500

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

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1851551311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11230 WAPLES MILL RD",
            "address_2": "SUITE 105",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306087",
            "telephone_number": "703-208-1500",
            "fax_number": "703-208-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11230 WAPLES MILL RD",
            "address_2": "SUITE 105",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306087",
            "telephone_number": "703-208-1500",
            "fax_number": "703-208-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "MALVOLIA",
        "middle_name": "LA FRANCES",
        "name_prefix": "Mrs.",
        "credential": "LPC    (IN TRAINING)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.