Healthcare Provider Details

I. General information

NPI: 1033762067
Provider Name (Legal Business Name): AMIRA YANNI LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date: 09/23/2021
Reactivation Date: 10/15/2021

III. Provider practice location address

3900 UNIVERSITY DR STE 130
FAIRFAX VA
22030-2513
US

IV. Provider business mailing address

325 ELLINGTON BLVD # 426
GAITHERSBURG MD
20878-4591
US

V. Phone/Fax

Practice location:
  • Phone: 240-972-7492
  • Fax:
Mailing address:
  • Phone: 240-972-7492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: