DEROSA WELLNESS INNOVATION, LLC
NPI 1124716519
Counselor - Professional in Reston, VA

Q: What is Derosa Wellness Innovation, LLC's NPI number?

The NPI number for Derosa Wellness Innovation, LLC is 1124716519. It was assigned to this organization in the NPPES registry on April 25, 2023.

Q: What is Derosa Wellness Innovation, LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Active since April 25, 2023

11921 FREEDOM DR STE 550, RESTON, VA 20190(703) 826-1353 Get Directions Write a Review

NPPES record last updated: April 26, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Derosa Wellness Innovation, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEROSA WELLNESS INNOVATION, LLC (NPI 1124716519) is a healthcare organization registered as a professional in Reston, Virginia and active in the NPI registry since April 2023. The organization lists Shirley Derosa, Director, as its authorized official.

NPPES Registry Identity

NPI1124716519

Entity TypeOrganization

Primary Taxonomy101YP2500X

Legal Business NameDEROSA WELLNESS INNOVATION, LLC

Location Address11921 FREEDOM DR STE 550Reston, VA 20190-5635

Mailing Address11921 Freedom Dr Ste 550Reston, VA 20190-5635 · (703) 826-1353

Phone(703) 826-1353

Organization SubpartNo

Authorized OfficialShirley DerosaDirector · (703) 826-1353

Enumeration DateApril 25, 2023

Last NPPES UpdateApril 26, 2023

NPPES CertifiedApril 26, 2023

✔ NPI 1124716519 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

11921 FREEDOM DR STE 550, Reston, VA 20190

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COMPASS BEHAVIORAL HEALTH PLLC

Clinic/Center (Multi-Specialty)

11921 FREEDOM DR STE 550
RESTON, VA 20190

Fairfax County (678) 617-2372

JULIA GRACE CYR NP

Nurse Practitioner (Psychiatric/Mental Health)

11921 FREEDOM DR STE 550
RESTON, VA 20190

Fairfax County (703) 783-4375

KATHERINE BUTTERS

Behavior Technician

11921 FREEDOM DR STE 550
RESTON, VA 20190

Fairfax County (800) 249-1266

SHIRLEY DEROSA LPC

Counselor (Professional)

11921 FREEDOM DR STE 550
RESTON, VA 20190

Fairfax County (703) 826-1353

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 Derosa Wellness Innovation, LLC's NPI number?

The NPI number for Derosa Wellness Innovation, LLC is 1124716519. It was assigned to this organization in the NPPES registry on April 25, 2023.

Where is Derosa Wellness Innovation, LLC located?

Derosa Wellness Innovation, LLC is located at 11921 Freedom Dr Ste 550, Reston, VA 20190. The listed phone number is (703) 826-1353.

What is Derosa Wellness Innovation, LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Derosa Wellness Innovation, LLC was last updated on April 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.