Healthcare Provider Details

I. General information

NPI: 1144115627
Provider Name (Legal Business Name): NAZAK COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46121 BRISBANE SQ
STERLING VA
20165-5850
US

IV. Provider business mailing address

46121 BRISBANE SQ
STERLING VA
20165-5850
US

V. Phone/Fax

Practice location:
  • Phone: 571-685-9036
  • Fax:
Mailing address:
  • Phone: 571-685-9036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: NAZAK HOSSEINI
Title or Position: PHD
Credential: LPC
Phone: 571-685-9036