Organization Active NPI

The Family Center Counseling Associates PLLC

Professional Counselor
Falls Church, VA

National Provider Identifier

1861571507

Registry record updated Jan 9, 2015

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Practitioners & affiliated clinicians
NPI Registry JSON
Other providers in Falls Church, VA
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Professional CounselorTaxonomy code 101YP2500X
License: 0701001168 Issued in VA
Legal business name: THE FAMILY CENTER COUNSELING ASSOCIATES PLLC
Practice address: 5691 Columbia Pike
Suite 200
Falls Church, VA 22041
Phone: (703) 998-5606
Fax: (703) 998-5608
NPI assigned: Nov 3, 2006
Last updated: Jan 9, 2015By the provider in NPPES
Organization subpart: No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Authorized official

Name: Dr. Glory Fox Dierker, PHDNPI 1750455937
Title: Executive Director
Phone: (703) 998-5606

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 11

Specialty (taxonomy)	Code	License	State	Primary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP	101YP2500X	07010001557	VA
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP	101YP2500X	0701001168	VA	Primary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP	101YP2500X	0701003275	VA
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP	103TC0700X	0810002996	VA
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP	103TC0700X	0810003091	VA
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP	103TC0700X	0810003059	VA
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP	103TC0700X	0810003411	VA
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP	103TC0700X	0810003272	VA
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP	103TC0700X	0810003575	VA
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP	103TC0700X	0810003667	VA
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP	106H00000X	0717000025	VA

Addresses

Primary practice location

5691 Columbia Pike
Suite 200
Falls Church, VA 22041

Mailing address

5691 Columbia Pike
Suite 200
Falls Church, VA 22041
Phone (703) 998-5606

Other identifiers 16

Identifier	Type	Issuer
149749000	Other	DEPARTMENT OF LABOR GLORY
28110014	Other	CAREFIRST FRAN
28110003	Other	CAREFIRST MARJORIE
141701	Other	ANTHEM BCBS GLORY
149749000	Other	DEPARTMENT OF LABOR FRAN
28110019	Other	CAREFIRST ERIKA
461335000	Other	MAGELLAN GLORY
775900000	Other	MAGELLAN RICH
097480	Other	ANTHEM BCBS MARJORIE
28110004	Other	CAREFIRST GLORY
254707000	Other	MAGELLAN MARJORIE
764249000	Other	MAGELLAN FAMILY CENTER
554781000	Other	MAGELLAN FRAN
818692000	Other	MAGELLAN ERIKA
175319	Other	ANTHEM BCBS GUS
28110017	Other	CAREFIRST RICH

Other names 1

The Family Center Counseling Associates PC Other name

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Enrolled in DC

Enrollment records 1

Enrollment ID	State	Provider type	PAC ID	Details
O20040331000613	DC	Part B Supplier - Clinic/Group Practice	1850383837	Receives reassigned benefits from 1 practitioner Practice locations: Falls Church, VA

National Provider Directory

Tax ID family: Family Center Counseling2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Family Center Counseling
- Clinical Psychologist
- Falls Church, VA
- NPI 1881872505
NPD tax ID

Locations

5695 Columbia Pike
#501
Falls Church, VA 22041
Phone (703) 998-5606

Practitioners & affiliated clinicians

Practitioners 17

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.

Glory Fox Dierker, PHD
- Clinical Psychologist
- Falls Church, VA
- NPI 1750455937
DC, Professional
Medicare reassignment NPD Authorized official
Deserie Melissa Charles, PHD
- Clinical Psychologist
- Falls Church, VA
- NPI 1902954498
NPD (past)
Jessica Lenore David
- Clinical Psychologist
- Fairfax, VA
- NPI 1962835637
NPD (past)
Marjorie B Deutsch, PHD LPC LMFT
- Professional Counselor
- Falls Church, VA
- NPI 1174611362
NPD (past)
Robert Allen Dierker II
- Mental Health Counselor
- Falls Church, VA
- NPI 1952260432
Multi-Specialty
NPD (past)
Johnathan Duff, PHD
- Psychologist
- Falls Church, VA
- NPI 1548734460
NPD (past)
Amy Ebeid, PSYD
- Clinical Psychologist
- Fairfax, VA
- NPI 1992893176
NPD (past)
Emily George
- Clinical Psychologist
- Falls Church, VA
- NPI 1891131272
NPD (past)
Richard Alan Gontang, PHD
- Clinical Psychologist
- Falls Church, VA
- NPI 1164505731
NPD (past)
Martha Rachel Gross, LPC
- Professional Counselor
- Falls Church, VA
- NPI 1164596342
NPD (past)
Ellen S McCrary-Mayer, PSYD
- Clinical Psychologist
- Falls Church, VA
- NPI 1083781504
NPD (past)
Gustavo Richard Nava, PHD
- Clinical Psychologist
- Falls Church, VA
- NPI 1902989593
NPD (past)

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1861571507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5691 COLUMBIA PIKE",
            "address_2": "SUITE 200",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "22041",
            "telephone_number": "703-998-5606",
            "fax_number": "703-998-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5691 COLUMBIA PIKE",
            "address_2": "SUITE 200",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "22041",
            "telephone_number": "703-998-5606",
            "fax_number": "703-998-5608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FAMILY CENTER COUNSELING ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "DIERKER",
        "authorized_official_first_name": "GLORY",
        "authorized_official_middle_name": "FOX",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "703-998-5606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "07010001557",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
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            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701003275",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002996",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003091",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003059",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003411",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003272",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003575",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003667",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717000025",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR GLORY",
            "identifier": "149749000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST FRAN",
            "identifier": "28110014",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MARJORIE",
            "identifier": "28110003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS GLORY",
            "identifier": "141701",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR FRAN",
            "identifier": "149749000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST ERIKA",
            "identifier": "28110019",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN GLORY",
            "identifier": "461335000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN RICH",
            "identifier": "775900000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS MARJORIE",
            "identifier": "097480",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST GLORY",
            "identifier": "28110004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN MARJORIE",
            "identifier": "254707000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN FAMILY CENTER",
            "identifier": "764249000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN FRAN",
            "identifier": "554781000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN ERIKA",
            "identifier": "818692000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS GUS",
            "identifier": "175319",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST RICH",
            "identifier": "28110017",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Family Center Counseling Associates PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Falls Church, VA

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.

Verify at the official NPI Registry.