Healthcare Provider Details

I. General information

NPI: 1114733011
Provider Name (Legal Business Name): NIVALIS COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2024
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 MAPLE AVE E STE 303D
VIENNA VA
22180-4743
US

IV. Provider business mailing address

450 MAPLE AVE E STE 303D
VIENNA VA
22180-4743
US

V. Phone/Fax

Practice location:
  • Phone: 703-755-0831
  • Fax:
Mailing address:
  • Phone: 703-755-0831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: IOANA MONTEL
Title or Position: OWNER
Credential: LCSW
Phone: 703-755-0831