Healthcare Provider Details

I. General information

NPI: 1033771753
Provider Name (Legal Business Name): GPC THERAPY ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2019
Last Update Date: 07/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 FOREST POINT CIR
MANASSAS VA
20110-4765
US

IV. Provider business mailing address

11601 CHAPEL RD
CLIFTON VA
20124-1907
US

V. Phone/Fax

Practice location:
  • Phone: 703-508-4578
  • Fax:
Mailing address:
  • Phone: 703-508-4578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. PHILIP CERRATO
Title or Position: OWNER, PSYCHOTHERAPIST
Credential: LCSW
Phone: 703-508-4578