Active NPI
Madalyn Humphreys, MA, CSOTP, LPC
- Professional Counselor
- Fairfax, VA
National Provider Identifier
1972172278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701010088
- Practice address
- 10623 Jones St Ste 301a
Fairfax, VA 22030-7512 - Phone
- (703) 267-5703
- NPI assigned
- Jun 21, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701010088 | VA | Primary |
Addresses
Primary practice location
10623 Jones St Ste 301a
Fairfax, VA 22030-7512
Mailing address
4800 28TH St S Apt H
Arlington, VA 22206-1300
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701010088 | VA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624233600000",
"number": "1972172278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4800 28TH ST S APT H",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "222061300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10623 JONES ST STE 301A",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220307512",
"telephone_number": "703-267-5703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUMPHREYS",
"first_name": "MADALYN",
"credential": "MA, CSOTP, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-21",
"last_updated": "2021-06-21",
"certification_date": "2021-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701010088",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.