Healthcare Provider Details

I. General information

NPI: 1568382406
Provider Name (Legal Business Name): TERESA SCHONDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1485 CHAIN BRIDGE RD STE 200
MC LEAN VA
22101-4501
US

IV. Provider business mailing address

1485 CHAIN BRIDGE RD STE 200
MC LEAN VA
22101-4501
US

V. Phone/Fax

Practice location:
  • Phone: 571-249-3620
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704019267
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: