Healthcare Provider Details

I. General information

NPI: 1992511869
Provider Name (Legal Business Name): APRIL GRANT MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44075 PIPELINE PLZ STE 300
ASHBURN VA
20147-5889
US

IV. Provider business mailing address

46929 FOXSTONE PL
STERLING VA
20165-3523
US

V. Phone/Fax

Practice location:
  • Phone: 301-221-9954
  • Fax:
Mailing address:
  • Phone: 301-221-9954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704017556
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: