Healthcare Provider Details

I. General information

NPI: 1184715138
Provider Name (Legal Business Name): NICHOLAS B LIAPPIS LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date: 01/13/2020
Reactivation Date: 01/17/2020

III. Provider practice location address

7415 SPORTSMAN DR
FALLS CHURCH VA
22043-1045
US

IV. Provider business mailing address

7415 SPORTSMAN DR
FALLS CHURCH VA
22043-1045
US

V. Phone/Fax

Practice location:
  • Phone: 703-705-2478
  • Fax:
Mailing address:
  • Phone: 703-705-2478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701003748
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: