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General NPI Number Information
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NPI Number | 1194867036
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Entity Type | Organization
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Legal Business Name | LOUDOUN FAMILY & RELATIONSHIP COUNSELING
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 215 LOUDOUN ST
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City | LEESBURG
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State | VA
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Zip | 20132
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Country | US
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Telephone | 703-771-7555
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Fax | 703-771-7556
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Provider Business Mailing Address
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Address Line | 215 LOUDOUN ST
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City | LEESBURG
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State | VA
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Zip | 20132
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Country | US
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Telephone | 703-771-7555
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Fax | 703-771-7556
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THERESA ANNA BEETON
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Credential | PH.D
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Telephone | 703-771-7555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | VA
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