=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295532935
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MRS. TOY LYNNE DRAINE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/28/2025
-----------------------------------------------------
Last Update Date | 12/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16033 EASY BIRD LOOP
-----------------------------------------------------
City | WOODBRIDGE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22191-6603
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-477-4194
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16033 EASY BIRD LOOP
-----------------------------------------------------
City | WOODBRIDGE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22191-6603
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-477-4194
-----------------------------------------------------
Fax | 617-807-0958
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 0701015541
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------