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General NPI Number Information
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NPI Number | 1154204535
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Entity Type | Individual
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Provider Name | SHAHBAZ KHAN
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Gender | Male
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 13431 CHRISTOPHER PL
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City | WOODBRIDGE
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State | VA
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Zip | 22192-3914
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Country | US
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Telephone | 703-935-9007
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Fax |
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Provider Business Mailing Address
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Address Line | 7481 ROUTE 29 APT 509
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City | FALLS CHURCH
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State | VA
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Zip | 22042-1719
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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