Healthcare Provider Details

I. General information

NPI: 1285085530
Provider Name (Legal Business Name): SAKINA FAHEEMAH BLUNT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SAKINA FAHEEMAH WRIGHT

II. Dates (important events)

Enumeration Date: 06/28/2016
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14011 WORTH AVE
WOODBRIDGE VA
22192-4123
US

IV. Provider business mailing address

14011 WORTH AVE
WOODBRIDGE VA
22192-4123
US

V. Phone/Fax

Practice location:
  • Phone: 703-792-7800
  • Fax:
Mailing address:
  • Phone: 703-792-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701016269
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: