Healthcare Provider Details

I. General information

NPI: 1669687380
Provider Name (Legal Business Name): DEAN CONSULTING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10470 ARMSTRONG ST
FAIRFAX VA
22030-3648
US

IV. Provider business mailing address

PO BOX 716
GAINESVILLE VA
20156-0716
US

V. Phone/Fax

Practice location:
  • Phone: 703-385-7575
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701003816
License Number StateVA

VIII. Authorized Official

Name: MATT DEAN
Title or Position: PRESIDENT
Credential:
Phone: 703-505-9014