Healthcare Provider Details

I. General information

NPI: 1326951880
Provider Name (Legal Business Name): NOVA MENTAL HEALTH COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

443B CARLISLE DR FL 2
HERNDON VA
20170-4802
US

IV. Provider business mailing address

2507 CAMBERWELL CT
HERNDON VA
20171-2981
US

V. Phone/Fax

Practice location:
  • Phone: 571-390-5339
  • Fax:
Mailing address:
  • Phone: 571-390-5339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. KATHERINE MENTAL HEALTH PANCIONE
Title or Position: CLINICAL DIRECTOR
Credential: LPC
Phone: 571-390-5339