Healthcare Provider Details

I. General information

NPI: 1467543173
Provider Name (Legal Business Name): PASTORAL COUNSELING OF NORTHERN VIRGINIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8800 SUDLEY RD
MANASSAS VA
20110-4409
US

IV. Provider business mailing address

4094 MAJESTIC LN #237
FAIRFAX VA
22033-2104
US

V. Phone/Fax

Practice location:
  • Phone: 703-449-1944
  • Fax:
Mailing address:
  • Phone: 703-449-1944
  • Fax: 703-361-9577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. GARY L HULME
Title or Position: PRESIDENT/CEO
Credential: D.MIN., AAPC
Phone: 703-449-1944