Healthcare Provider Details

I. General information

NPI: 1376489740
Provider Name (Legal Business Name): OAK TREE COUNSELING AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 W BROAD ST STE B3
FALLS CHURCH VA
22046-3222
US

IV. Provider business mailing address

712 W BROAD ST STE B3
FALLS CHURCH VA
22046-3222
US

V. Phone/Fax

Practice location:
  • Phone: 571-500-8516
  • Fax:
Mailing address:
  • Phone: 571-500-8516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MISS CHEREEN TREE CW GAMAL
Title or Position: OWNER
Credential: LPC
Phone: 571-500-8516