Healthcare Provider Details

I. General information

NPI: 1871424572
Provider Name (Legal Business Name): HEALING MOSAIC COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8709 FLOWERING DOGWOOD LN
LORTON VA
22079-5602
US

IV. Provider business mailing address

11166 FAIRFAX BLVD STE 500
FAIRFAX VA
22030-5017
US

V. Phone/Fax

Practice location:
  • Phone: 571-325-0976
  • Fax:
Mailing address:
  • Phone: 571-325-0976
  • 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: DR. KAYCEE COLON ROBERTS
Title or Position: OWNER
Credential: LPC
Phone: 325-227-1461