Healthcare Provider Details

I. General information

NPI: 1104673342
Provider Name (Legal Business Name): ABIGAIL COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6841 ELM ST UNIT 442
MC LEAN VA
22101-8016
US

IV. Provider business mailing address

PO BOX 442
MC LEAN VA
22101-0442
US

V. Phone/Fax

Practice location:
  • Phone: 571-888-5140
  • Fax:
Mailing address:
  • Phone: 571-888-5140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. OWEN ESLINGER
Title or Position: CFO
Credential:
Phone: 571-888-5140