Healthcare Provider Details

I. General information

NPI: 1699107946
Provider Name (Legal Business Name): WILLIAM REDMILES, LPC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2013
Last Update Date: 08/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8140 ASHTON AVE SUITE 100
MANASSAS VA
20109-5698
US

IV. Provider business mailing address

8140 ASHTON AVE SUITE 100
MANASSAS VA
20109-5698
US

V. Phone/Fax

Practice location:
  • Phone: 703-244-6940
  • Fax: 703-330-3966
Mailing address:
  • Phone: 703-244-6940
  • Fax: 703-330-3966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM FRANKLIN REDMILES
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 703-244-6940