Individual provider Active NPI

Leslie Courtney Roberts, LPC, MED, CSAC

  • Mental Health Counselor
  • Reston, VA
National Provider Identifier
1962831198
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701005548 Issued in VA
Practice address
1850 Cameron Glen Dr Ste 600
Reston, VA 20190-3343
Phone
(703) 481-4174
Fax
(703) 435-1961
NPI assigned
Nov 7, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0701005548 VA Primary

Addresses

Primary practice location

1850 Cameron Glen Dr Ste 600
Reston, VA 20190-3343

Mailing address

1850 Cameron Glen Dr Ste 600
Reston, VA 20190-3343
Phone (703) 481-4174

Other identifiers 1

IdentifierTypeStateIssuer
120705OtherVAFX CO EMPLOYEE NUMBER

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
0701005548VAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1962831198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 CAMERON GLEN DR STE 600",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903343",
            "telephone_number": "703-481-4174",
            "fax_number": "703-435-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 CAMERON GLEN DR STE 600",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903343",
            "telephone_number": "703-481-4174",
            "fax_number": "703-435-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "LESLIE",
        "middle_name": "COURTNEY",
        "name_prefix": "Mrs.",
        "credential": "LPC, MED, CSAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701005548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FX CO EMPLOYEE NUMBER",
            "identifier": "120705",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.