Healthcare Provider Details

I. General information

NPI: 1699157974
Provider Name (Legal Business Name): PRIYA BAJAJ LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2015
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 BEVERLY RD STE 200
MC LEAN VA
22101-3647
US

IV. Provider business mailing address

1360 BEVERLY RD STE 200
MC LEAN VA
22101-3647
US

V. Phone/Fax

Practice location:
  • Phone: 844-863-4621
  • Fax: 804-447-3352
Mailing address:
  • Phone: 844-863-4621
  • Fax: 804-447-3352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC017017
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701016587
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: