| Northern Virginia Older Adult Counseling | |
|
4700 Banting Ct Fairfax VA 22032-2451 | |
| (703) 424-0410 | |
| Not Available |
| Full Name | Northern Virginia Older Adult Counseling |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4700 Banting Ct, Fairfax, Virginia |
| Authorized Official Name and Position | Susan M Johnson (PARTNER/OPERATIONS OFFICER) |
| Authorized Official Contact | 7034240410 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Virginia Older Adult Counseling 4700 Banting Ct Fairfax VA 22032-2451 Ph: (703) 424-0410 | Northern Virginia Older Adult Counseling 4700 Banting Ct Fairfax VA 22032-2451 Ph: (703) 424-0410 |
| NPI Number | 1831569896 |
|---|---|
| Provider Enumeration Date | 10/03/2015 |
| Last Update Date | 02/04/2016 |
| Medicare PECOS PAC ID | 5294039608 |
|---|---|
| Medicare Enrollment ID | O20160205000052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831569896 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0904006279 (Virginia) | Primary |
| Provider Name | Marilyn R Gebel Sitts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437135639 PECOS PAC ID: 9335320803 Enrollment ID: I20110217000162 |
| Provider Name | Shirley Metzger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710342571 PECOS PAC ID: 5991009300 Enrollment ID: I20160205000496 |
| Provider Name | Kathleen S Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437694551 PECOS PAC ID: 3274818125 Enrollment ID: I20170316001271 |
| Provider Name | Colleen L Turner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790215739 PECOS PAC ID: 2062782568 Enrollment ID: I20170717000746 |
| Provider Name | Ronald P Longo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710423306 PECOS PAC ID: 5698049641 Enrollment ID: I20170914003221 |
| Provider Name | Karyn B Walsh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700364130 PECOS PAC ID: 4284985094 Enrollment ID: I20180918001937 |
| Provider Name | Christin Dougherty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144796061 PECOS PAC ID: 3678819711 Enrollment ID: I20190110003433 |
| Provider Name | Elizabeth B Dakin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699276543 PECOS PAC ID: 8820336712 Enrollment ID: I20190219003279 |
| Provider Name | Ashley S Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164074431 PECOS PAC ID: 6002147089 Enrollment ID: I20191004001695 |
| Provider Name | Dorine K Ndayizigiye |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790323467 PECOS PAC ID: 1658707336 Enrollment ID: I20200129001918 |
| Provider Name | Joyce L Montgomery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790318236 PECOS PAC ID: 9436587128 Enrollment ID: I20200311001248 |
| Provider Name | Miriam T Mckain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013540558 PECOS PAC ID: 9638507601 Enrollment ID: I20200325002764 |
| Provider Name | Lorraine Vrsecky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750902342 PECOS PAC ID: 2163843319 Enrollment ID: I20200527000375 |
| Provider Name | Alicea Ardito |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700409075 PECOS PAC ID: 9638590193 Enrollment ID: I20200609001622 |
| Provider Name | Janae Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871189357 PECOS PAC ID: 9234542143 Enrollment ID: I20210114001792 |
| Provider Name | Stephanie C Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932798261 PECOS PAC ID: 8527472737 Enrollment ID: I20210129001921 |
| Provider Name | Chesley Harris Simpson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790352193 PECOS PAC ID: 6709287790 Enrollment ID: I20210629000107 |
| Provider Name | Jennifer G Lanouette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669147765 PECOS PAC ID: 5890191829 Enrollment ID: I20210831000883 |
| Provider Name | Brooke L Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265724009 PECOS PAC ID: 9931371101 Enrollment ID: I20210907001966 |
| Provider Name | Elaine D Delbianco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629745526 PECOS PAC ID: 5597153668 Enrollment ID: I20211021001778 |
| Provider Name | Michael Ridge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114699048 PECOS PAC ID: 1355739434 Enrollment ID: I20211021002009 |
| Provider Name | Adele S Denny |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497401269 PECOS PAC ID: 8022404862 Enrollment ID: I20220405000598 |
| Provider Name | Victoria Tripp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558003574 PECOS PAC ID: 5991180929 Enrollment ID: I20220912003003 |
| Provider Name | Ruth A Talley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023470010 PECOS PAC ID: 8527439934 Enrollment ID: I20230123002195 |
| Provider Name | Marguerite L Lawless |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083392146 PECOS PAC ID: 1951763036 Enrollment ID: I20230822001790 |
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