NORTHERN LIGHTS PSYCHOTHERAPY
NPI 1104450105
Psychologist - Clinical in Leesburg, VA
About Northern Lights Psychotherapy NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NORTHERN LIGHTS PSYCHOTHERAPY (NPI 1104450105) is a healthcare organization registered as a clinical in Leesburg, Virginia and active in the NPI registry since February 2020. The organization lists Sofia A Graham, Clinical Psychologist/owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Northern Lights Psychotherapy is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Northern Lights Psychotherapy, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Northern Lights Psychotherapy's NPI number?
The NPI number for Northern Lights Psychotherapy is 1104450105. It was assigned to this organization in the NPPES registry on February 27, 2020.
Where is Northern Lights Psychotherapy located?
Northern Lights Psychotherapy is located at 222 Catoctin Cir SE Ste 126, Leesburg, VA 20175. The listed phone number is (571) 477-1613.
What is Northern Lights Psychotherapy's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Northern Lights Psychotherapy enrolled in Medicare?
Yes. Northern Lights Psychotherapy is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Northern Lights Psychotherapy?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Northern Lights Psychotherapy. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Northern Lights Psychotherapy was last updated on February 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Northern Lights Psychotherapy · NPI 1104450105
Clinical organization in Leesburg, Virginia. Organization record, active in the CMS NPPES registry since February 27, 2020.
## Identity
- **NPI:** 1104450105 (Entity type: Organization)
- **Enumerated:** February 27, 2020
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **Organization subpart:** No
- **Authorized official:** Sofia Graham, CLINICAL PSYCHOLOGIST/OWNER
## Practice location
- **Address:** 222 CATOCTIN CIR SE STE 126, Leesburg, VA 20175-3730
- **Phone:** (571) 477-1613
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Clinical Psychologist) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 27, 2020
- **Other identifiers:** Medicaid 1104228121 (VA)
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Source: [NPI Profile](https://npiprofile.com/npi/1104450105) · Data from the CMS NPPES public registry.