Healthcare Provider Details

I. General information

NPI: 1700207685
Provider Name (Legal Business Name): REBECCA GLEED LMFT MA PMH-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2013
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10805 MAIN ST STE 400
FAIRFAX VA
22030-4747
US

IV. Provider business mailing address

10805 MAIN ST STE 400
FAIRFAX VA
22030-4747
US

V. Phone/Fax

Practice location:
  • Phone: 703-638-9289
  • Fax:
Mailing address:
  • Phone: 703-638-9289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0171001299
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0717001299
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: