Matthew Archer Blomme, MA
Individual provider Active NPI Counselor · Alexandria, VA
NPI 1962230953 · NPPES record last updated Jul 23, 2024
Key facts
- NPI
- 1962230953
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 0704017147 (VA)
- Practice address
- 112 S Pitt St
Alexandria, VA 22314-3112 - Phone
- (703) 534-5100
- NPI assigned
- Jul 23, 2024
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0704017147 | VA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunstone Counseling, PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 0704017147 | VA | Yes |
Addresses
Primary practice location
112 S Pitt St
Alexandria, VA 22314-3112
Mailing address
112 S Pitt St
Alexandria, VA 22314-3112
Phone (703) 534-5100
Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.