Active NPI
Amanda George
- Mental Health Counselor
- Leesburg, VA
National Provider Identifier
1962050575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0701008123
- Practice address
- 44084 Riverside Pkwy
Leesburg, VA 20176-8279 - Phone
- (703) 724-0300
- NPI assigned
- Aug 27, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0701008123 | VA | Primary |
Addresses
Primary practice location
44084 Riverside Pkwy
Leesburg, VA 20176-8279
Mailing address
44084 Riverside Pkwy
Leesburg, VA 20176-8279
Phone (757) 334-3578
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | frontdesk@riversidecounseling.net |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701008123 | VA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627344000000",
"number": "1962050575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44084 RIVERSIDE PKWY",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201768279",
"telephone_number": "757-334-3578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44084 RIVERSIDE PKWY",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201768279",
"telephone_number": "703-724-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEORGE",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-27",
"last_updated": "2021-07-27",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VA",
"license": "0701008123",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "frontdesk@riversidecounseling.net",
"affiliation": "N",
"address_1": "44084 Riverside Pkwy Ste 240",
"city": "Leesburg",
"state": "VA",
"country_code": "US",
"postal_code": "201765102",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Leesburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.