Healthcare Provider Details

I. General information

NPI: 1477483766
Provider Name (Legal Business Name): INTEGRATIVE COUNSELING SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13203 OLD DELANEY RD
WOODBRIDGE VA
22193-4850
US

IV. Provider business mailing address

13203 OLD DELANEY RD
WOODBRIDGE VA
22193-4850
US

V. Phone/Fax

Practice location:
  • Phone: 703-498-7403
  • Fax: 703-580-1964
Mailing address:
  • Phone: 703-498-7403
  • Fax: 703-580-1964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. SANDRA MOLLE
Title or Position: OWNER
Credential: LPC
Phone: 703-498-7403