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NPI Code Detail

MEDICARE: ANA BETHENCOURT YRAUSQUIN

MEDICARE:   ANA  BETHENCOURT YRAUSQUIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NOTHERN

General Provider Information

NPI Number : 1740942747
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANA BETHENCOURT YRAUSQUIN
Provider Business Mailing Address
First Line : 6702 JEFFERSON AVE
Second Line :
City : FALLS CHURCH
State : VA
Zip : 22042-2104
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 124 E BROAD ST
Second Line :
City : FALLS CHURCH
State : VA
Zip : 22046-4529
Country : US
Telephone Number : 703-534-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2021
Last Update Date : 10/07/2021

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Directions to “ ANA BETHENCOURT YRAUSQUIN ” Practice Location

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