Individual provider Active NPI

Melaina Neyer Garrison, LMFT

  • Marriage & Family Therapist
  • Reston, VA
National Provider Identifier
1972992386
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
0717001599 Issued in VA
Practice address
11160-C1 South Lakes Dr.
#144
Reston, VA 20191
Phone
(571) 377-8683
Fax
(859) 578-3273
NPI assigned
Jan 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 240382 KY
Marriage & Family Therapist 106H00000X 0717001599 VA Primary

Addresses

Primary practice location

11160-C1 South Lakes Dr.
#144
Reston, VA 20191

Mailing address

11160-C1 South Lakes Dr.
#144
Reston, VA 20191
Phone (571) 377-8683

Other identifiers 1

IdentifierTypeStateIssuer
610661458OtherKYTAX ID

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

LicenseStateTypeSpecialty
240382KYMDMarriage & Family Therapist
0717001599VAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1972992386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11160-C1 SOUTH LAKES DR.",
            "address_2": "#144",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "20191",
            "telephone_number": "571-377-8683",
            "fax_number": "859-578-3273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11160-C1 SOUTH LAKES DR.",
            "address_2": "#144",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "20191",
            "telephone_number": "571-377-8683",
            "fax_number": "859-578-3273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRISON",
        "first_name": "MELAINA",
        "middle_name": "NEYER",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "240382",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717001599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "610661458",
            "state": "KY"
        }
    ],
    "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 Dec 2, 2020; 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.