Healthcare Provider Details

I. General information

NPI: 1881216349
Provider Name (Legal Business Name): SAFIA ABULAILA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2020
Last Update Date: 05/07/2020
Certification Date: 05/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8221 WILLOW OAKS CORPORATE DR STE 4-430
FAIRFAX VA
22031-4512
US

IV. Provider business mailing address

6024 TIMBER HOLLOW LN
SPRINGFIELD VA
22152-1432
US

V. Phone/Fax

Practice location:
  • Phone: 703-289-7560
  • Fax:
Mailing address:
  • Phone: 908-461-8569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701009029
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: