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MICHAEL ROBERT FORMICHELLA MS
NPI 1386201382
Counselor - Mental Health in Leesburg, VA

Active since May 24, 2019PECOS Enrolled
102 HERITAGE WAY NE STE 302, LEESBURG, VA 20176(703) 771-5100(703) 777-0170 Get Directions Write a Review

NPPES record last updated: December 19, 2022. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Dec 19, 2022, May 24, 2019 (2 updates tracked since 2019).

About Michael Robert Formichella Ms NPPES

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

MICHAEL ROBERT FORMICHELLA MS (NPI 1386201382) is an individual mental health provider in Leesburg, Virginia, licensed in Virginia (0701012019) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1386201382
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMICHAEL ROBERT FORMICHELLACredential: MS
Location Address102 HERITAGE WAY NE STE 302Leesburg, VA 20176-4544
Mailing Address102 Heritage Way Ne, Suite 302 Po Box 7400Leesburg, VA 20177-7400 · (703) 771-5100 · Fax (703) 777-0170
Phone(703) 771-5100
Fax(703) 777-0170
Sole ProprietorYes
Enumeration DateMay 24, 2019
Last NPPES UpdateDecember 19, 20222 updates tracked since enumeration
NPPES CertifiedDecember 19, 2022
✔ NPI 1386201382 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in VA · 0701012019
102 HERITAGE WAY NE STE 302, Leesburg, VA 20176
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael Robert Formichella Ms is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

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

KATHERINE CAMPBELL
Case Manager/Care Coordinator
102 HERITAGE WAY NE STE 302
LEESBURG, VA 20176
Loudoun County (571) 577-3402
ERKA MUCAJ LPC
Counselor (Mental Health)
102 HERITAGE WAY NE STE 302
LEESBURG, VA 20176
Loudoun County (703) 771-5100
MRS. SONAL ANEIL BUTANI
Counselor
102 HERITAGE WAY NE STE 302
LEESBURG, VA 20176
Loudoun County (703) 771-5100
JONI ELIZABETH RODRIGUEZ LPC
Counselor (Mental Health)
102 HERITAGE WAY NE STE 302
LEESBURG, VA 20176
Loudoun County (703) 771-5100
WILLIAM GATEWOOD
Case Manager/Care Coordinator
102 HERITAGE WAY NE STE 302
LEESBURG, VA 20176
Loudoun County (703) 771-5300
MICHELLE MARTIN LCSW
Social Worker (Clinical)
102 HERITAGE WAY NE STE 302
LEESBURG, VA 20176
Loudoun County (703) 771-5100
MS. JOHNI J. SPINELLI M.ED.
Counselor (Mental Health)
102 HERITAGE WAY NE STE 302
LEESBURG, VA 20176
Loudoun County (703) 771-5100
DR. STACEY LEE WARING PH.D.
Psychologist (Clinical)
102 HERITAGE WAY NE STE 302
LEESBURG, VA 20176
Loudoun County (703) 771-5100

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 Michael Formichella's NPI number?

The NPI number for Michael Formichella is 1386201382. It was assigned to this individual provider in the NPPES registry on May 24, 2019.

Where is Michael Formichella located?

Michael Formichella practices at 102 Heritage Way NE Ste 302, Leesburg, VA 20176. The listed phone number is (703) 771-5100.

What is Michael Formichella's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Michael Formichella enrolled in Medicare?

Yes. Michael Formichella is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Michael Formichella was last updated on December 19, 2022. 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.