Healthcare Provider Details

I. General information

NPI: 1144555046
Provider Name (Legal Business Name): YASAMAN ALAVI LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2009
Last Update Date: 10/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5880 HUBBARD DR
ROCKVILLE MD
20852-4821
US

IV. Provider business mailing address

10 BEACON HILL WAY
GAITHERSBURG MD
20878-1969
US

V. Phone/Fax

Practice location:
  • Phone: 301-977-0824
  • Fax:
Mailing address:
  • Phone: 301-401-2166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC7867
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: