Healthcare Provider Details

I. General information

NPI: 1427798032
Provider Name (Legal Business Name): CAROLYN MARIE RAUFER NCC, CSAC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 S GLEBE RD STE 300
ARLINGTON VA
22204-1672
US

IV. Provider business mailing address

46 S GLEBE RD STE 300
ARLINGTON VA
22204-1672
US

V. Phone/Fax

Practice location:
  • Phone: 703-841-0703
  • Fax: 703-243-7956
Mailing address:
  • Phone: 703-841-0703
  • Fax: 703-243-7956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701011340
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: