Healthcare Provider Details

I. General information

NPI: 1255099487
Provider Name (Legal Business Name): APGTHERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2021
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44121 HARRY BYRD HWY STE 240
ASHBURN VA
20147-5668
US

IV. Provider business mailing address

44121 HARRY BYRD HWY STE 240
ASHBURN VA
20147-5668
US

V. Phone/Fax

Practice location:
  • Phone: 703-977-2215
  • Fax: 571-410-0218
Mailing address:
  • Phone: 703-977-2215
  • Fax: 571-410-0218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANA PAULA GONCALVES
Title or Position: OWNER AND MENTAL HEALTH THERAPIST
Credential: LPC, NCC
Phone: 703-977-2215