Shally Vaid, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701011923 Issued in VA

Practice address

20116 Ashbrook PL Ste 110120
Ashburn, VA 20147-5086

Phone

(571) 977-5298

NPI assigned

Apr 15, 2010

Reactivated

Apr 25, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Bright Path Therapy and Wellness Center

  • Professional Counselor
  • Alpharetta, GA
  • NPI 1528620051
  NPD Authorized official

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1912223934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 BIRMINGHAM RD STE 501-385",
            "city": "MILTON",
            "state": "GA",
            "postal_code": "300044417",
            "telephone_number": "678-209-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20116 ASHBROOK PL STE 110120",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475086",
            "telephone_number": "571-977-5298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1071 Cambridge Sq Ste Aandb",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300091843",
            "country_code": "US",
            "telephone_number": "678-209-1732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAID",
        "first_name": "SHALLY",
        "name_prefix": "Mrs.",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "deactivation_date": "2023-02-23",
        "reactivation_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC006531",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701011923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyson Urgent Care, LLC (ExpressCare of Ashburn)
• Courtney J Ullrich, DMD
• Sital Unadkat
• Tara Lynn Urschel, D.C.
• Adil Usman, M.D.
• Ana M Valderrama
• Michelle Valderrama
• Valerie V Woo DMD PC (NOVA Pediatric Dentistry)
• Neelima Vallepalli
• Cassidy Van Bevers, DC

• Professional Counselor in Ashburn, VA
• Providers in Ashburn, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.