Healthcare Provider Details

I. General information

NPI: 1881517175
Provider Name (Legal Business Name): BRANDON LEE VILLATORO-SORTO LGPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8701 GEORGIA AVE STE 411
SILVER SPRING MD
20910-3713
US

IV. Provider business mailing address

8701 GEORGIA AVE STE 411
SILVER SPRING MD
20910-3713
US

V. Phone/Fax

Practice location:
  • Phone: 202-964-3957
  • Fax:
Mailing address:
  • Phone: 202-964-3957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP18251
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: