Mary Ellen Everett, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0904005256 Issued in VA

Practice address

7450 Heritage Village Plaza Dr.
Suite 101
Gainesville, VA 20155

Phone

(703) 989-0786

Fax

(571) 261-1170

NPI assigned

Jan 23, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Ellen Cordisco Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 23, 2017 through Jan 23, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Loudoun, Virginia

  dba Loudoun County Health Department

  • State or Local Public Health Clinic/Center
  • Leesburg, VA
  • NPI 1588353569
  NPD (past)
• Gainesville Professional Counseling Center

  • Professional Counselor
  • Gainesville, VA
  • NPI 1427386929
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912051376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 HERITAGE VILLAGE PLAZA DR.",
            "address_2": "SUITE 101",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "20155",
            "telephone_number": "703-989-0786",
            "fax_number": "571-261-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 HERITAGE VILLAGE PLAZA DR.",
            "address_2": "SUITE 101",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "20155",
            "telephone_number": "703-989-0786",
            "fax_number": "571-261-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERETT",
        "first_name": "MARY ELLEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0904005256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ELLEN",
            "last_name": "CORDISCO",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Gainesville, VA
• Providers in Gainesville, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.