Active NPI
Eleonora Sadikova
- Mental Health Counselor
- Rockville, MD
National Provider Identifier
1972039634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 9707 Key West Ave Ste 100
Rockville, MD 20850-3992 - Phone
- (240) 750-6467
- NPI assigned
- May 2, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810008678 | VA | |
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
9707 Key West Ave Ste 100
Rockville, MD 20850-3992
Mailing address
4132 E Jack Jouett Rd
Louisa, VA 23093-3140
Phone (703) 405-9723
Other practice location 1
4132 E Jack Jouett Rd
Louisa, VA 23093-3140
Phone (703) 405-9723
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 |
|---|---|---|---|
| 0810008678 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733097600000",
"number": "1972039634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4132 E JACK JOUETT RD",
"city": "LOUISA",
"state": "VA",
"postal_code": "230933140",
"telephone_number": "703-405-9723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9707 KEY WEST AVE STE 100",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208503992",
"telephone_number": "240-750-6467"
}
],
"practiceLocations": [
{
"address_1": "4132 E Jack Jouett Rd",
"address_purpose": "LOCATION",
"city": "Louisa",
"state": "VA",
"postal_code": "230933140",
"country_code": "US",
"telephone_number": "703-405-9723",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SADIKOVA",
"first_name": "ELEONORA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-02",
"last_updated": "2024-12-02",
"certification_date": "2024-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810008678",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.