Healthcare Provider Details

I. General information

NPI: 1821116435
Provider Name (Legal Business Name): AMELIA CAROLYN CIAMBRUSCHINI LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMELIA CAROLYN FRETZ LPC

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44121 LEESBURG PIKE STE 255
ASHBURN VA
20147-5671
US

IV. Provider business mailing address

44121 LEESBURG PIKE STE 255
ASHBURN VA
20147-5671
US

V. Phone/Fax

Practice location:
  • Phone: 703-887-6932
  • Fax:
Mailing address:
  • Phone: 703-887-6932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701003537
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: