Healthcare Provider Details

I. General information

NPI: 1790443992
Provider Name (Legal Business Name): BEHIND THE VEIL CONSULTATIONS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2021
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12531 CLIPPER DR STE 202-7
WOODBRIDGE VA
22192-2518
US

IV. Provider business mailing address

PO BOX 1171
DUMFRIES VA
22026-9171
US

V. Phone/Fax

Practice location:
  • Phone: 855-969-7877
  • Fax:
Mailing address:
  • Phone:
  • 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: TANYKA ABBOTT
Title or Position: OWNER/THERAPIST
Credential: LCSW
Phone: 804-536-7232