Healthcare Provider Details

I. General information

NPI: 1356297790
Provider Name (Legal Business Name): GENEVIEVE JOANN COOLEY M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 SILVER HILL DR APT 2005
MC LEAN VA
22102-3080
US

IV. Provider business mailing address

4806 PHILPOTT DR
BASSETT VA
24055-4773
US

V. Phone/Fax

Practice location:
  • Phone: 571-339-0193
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: