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INOVA KELLAR CENTER
NPI 1497808679
Clinic/Center - Adolescent and Children Mental Health in Fairfax, VA

Active since January 19, 2007CLIA Certified · 2 labs
11204 WAPLES MILL RD, FAIRFAX, VA 22030(703) 218-8500(703) 359-0463 Get Directions Write a Review

NPPES record last updated: April 30, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 30, 2026, Feb 7, 2024, Oct 16, 2018 (3 updates tracked since 2018).

About Inova Kellar Center NPPES

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

INOVA KELLAR CENTER (NPI 1497808679) is a healthcare organization registered as an adolescent and children mental health in Fairfax, Virginia and active in the NPI registry since January 2007. The organization holds 2 active CLIA laboratory certificates, maintains 2 additional practice locations, and lists Rick Leichtweis, Senior Director, as its authorized official.

NPPES Registry Identity

NPI1497808679
Entity TypeOrganization
Primary Taxonomy261QM0855X
Legal Business NameINOVA KELLAR CENTER
Location Address11204 WAPLES MILL RDFairfax, VA 22030-6048
Mailing AddressPo Box 37511Baltimore, MD 21297-3511 · (703) 218-8500 · Fax (703) 359-0463
Phone(703) 218-8500
Fax(703) 359-0463
Organization SubpartNo
Authorized OfficialRick LeichtweisSenior Director · (703) 218-8500
Enumeration DateJanuary 19, 2007
Last NPPES UpdateApril 30, 20263 updates tracked since enumeration
NPPES CertifiedApril 30, 2026
✔ NPI 1497808679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Adolescent and Children Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0855X
License✔ Licensed in VA · 033
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X
11204 WAPLES MILL RD, Fairfax, VA 22030
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Secondary Practice Locations 2

Location 146050 Manekin Plz Ste 110Sterling, VA 20166-6519 · Phone (571) 665-6710
Location 211200 Waples Mill Rd Ste 180Fairfax, VA 22030-7407 · Phone (703) 218-8500

Other Identifiers 1

Medicaid4943902VA

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D2177287

Inova Kellar Center · Fairfax, VA
Active · expires Jan 7, 2028
CLIA Number49D2177287
Laboratory TypeBehavioral Health Out Pat
Certificate Effective DateJanuary 8, 2026
Certificate Expiration DateJanuary 7, 2028
Laboratory DirectorSonia Thomas
Laboratory Phone(703) 218-8510
Laboratory LocationInova Kellar Center11204 Waples Mill Road, Fairfax, VA 22030
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 49D2177288

Inova Kellar Center · Sterling, VA
Active · expires Jan 7, 2028
CLIA Number49D2177288
Laboratory TypeBehavioral Health Outpat
Certificate Effective DateJanuary 8, 2026
Certificate Expiration DateJanuary 7, 2028
Laboratory DirectorSonia Thomas
Laboratory Phone(571) 665-6710
Laboratory LocationInova Kellar Center46050 Manekin Plaza Suite 110, Sterling, VA 20166
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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.

DR. RAVINDERPAL SINGH M.D,
Psychiatry & Neurology (Child & Adolescent Psychiatry)
11204 WAPLES MILL RD
FAIRFAX, VA 22030
Fairfax City (703) 218-8500
HITOMI MAKINO
Counselor (Mental Health)
11204 WAPLES MILL RD
FAIRFAX, VA 22030
Fairfax City (703) 218-8500
ELIZABETH ANNE BROCATO LCSW
Social Worker (Clinical)
11204 WAPLES MILL RD
FAIRFAX, VA 22030
Fairfax City (703) 218-8571
STEPHANIE RENEE MAYRANT MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
11204 WAPLES MILL RD
FAIRFAX, VA 22030
Fairfax City (703) 218-8500
MICHELLE HENDRICKSON PH.D.
Psychologist (Clinical Child & Adolescent)
11204 WAPLES MILL RD
FAIRFAX, VA 22030
Fairfax City (703) 218-2913
MS. SARAH JUNGSOO LIM LPC
Counselor (Professional)
11204 WAPLES MILL RD
FAIRFAX, VA 22030
Fairfax City (703) 218-8500
JANET GREIDER LPC
Counselor
11204 WAPLES MILL RD
FAIRFAX, VA 22030
Fairfax City (703) 218-8500
DR. CATHERINE A RATHMAN PH.D.
Psychologist (Clinical Child & Adolescent)
11204 WAPLES MILL RD
FAIRFAX, VA 22030
Fairfax City (703) 218-8536

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 Inova Kellar Center's NPI number?

The NPI number for Inova Kellar Center is 1497808679. It was assigned to this organization in the NPPES registry on January 19, 2007.

Where is Inova Kellar Center located?

Inova Kellar Center is located at 11204 Waples Mill Rd, Fairfax, VA 22030. The listed phone number is (703) 218-8500.

What is Inova Kellar Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adolescent and Children Mental Health, with taxonomy code 261QM0855X.

Does Inova Kellar Center hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Inova Kellar Center was last updated on April 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.