SAFE HARBOR BEHAVIORAL CARE OF NORTHERN VIRGINIA LLC – Professional Counselor, NPI 1043660905
Professional Counselor
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for SAFE HARBOR BEHAVIORAL CARE OF NORTHERN VIRGINIA LLC
8304, Old Keene Mill Road, Fairfax Park, Westview Hills, West Springfield, Fairfax County, Virginia, 22152, United States
SPRINGFIELD, VA 221521640
Phone: (410) 893-4600
Fax: (443) 640-4358
Type: Location
8020, Greeley Boulevard, Westview Hills, West Springfield, Fairfax County, Virginia, 22152, United States
SPRINGFIELD, VA 221523001
Phone:
Type: Mailing
547 TWIN LAKES LN
BUMPASS, VA 230244671
Phone: (410) 893-4600
Fax: (443) 640-4358
Type: Mailing
6408 GROVEDALE DR STE 200
ALEXANDRIA, VA 223102596
Phone: (410) 893-4600
Fax: (443) 640-4358
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-12-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-12-31 (894 days ago).
Enrollment records
1
Earliest due date
2023-12-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20161219001684 | O | Clinic/Group Practice | DC | 2023-12-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 22152)
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