Healthcare Provider Details

I. General information

NPI: 1366217739
Provider Name (Legal Business Name): SIT AWHILE & HEAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2023
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18223 SUMMIT POINTE DR
TRIANGLE VA
22172-1136
US

IV. Provider business mailing address

14497 POTOMAC MILLS RD # 1159
WOODBRIDGE VA
22192-6807
US

V. Phone/Fax

Practice location:
  • Phone: 571-406-3144
  • Fax: 703-783-6752
Mailing address:
  • Phone: 571-406-3144
  • Fax: 703-783-6752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: PALESA ABENAA OSEI-TUTU
Title or Position: CEO/LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 804-651-9052