MEDICARE: MS. BHARATI PATEL LPC

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCA333	MD
2	101YP2500X	Professional Counselor	LC0413	MD
3	101YP2500X	Professional Counselor	0701003367	VA

General Provider Information

NPI Number	:	1750394615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BHARATI PATEL LPC

Provider Business Mailing Address
First Line	:	8221 WILLOW OAKS CORPORATE DR
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-4512
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8221 WILLOW OAKS CORPORATE DR
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-4512
Country	:	US
Telephone Number	:	703-559-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	02/01/2024

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