Healthcare Provider Details

I. General information

NPI: 1730318437
Provider Name (Legal Business Name): BETH B. CUJE ED.D., LPC, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2009
Last Update Date: 07/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4390 LORCOM LANE NO. 409
ARLINGTON VA
22207-3327
US

IV. Provider business mailing address

4390 LORCOM LANE NO. 409
ARLINGTON VA
22207-3327
US

V. Phone/Fax

Practice location:
  • Phone: 703-536-1836
  • Fax: 703-536-1836
Mailing address:
  • Phone: 703-536-1836
  • Fax: 703-536-1836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701-000674
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0717000092
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: