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General NPI Number Information
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NPI Number | 1336613439
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Entity Type | Organization
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Legal Business Name | SYNERGY COUNSELING, LLC
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Dates
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Enumeration Date | 01/11/2019
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Last Update Date | 01/11/2019
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Provider Practice Location Address
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Address Line | 10379B DEMOCRACY LN
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City | FAIRFAX
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State | VA
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Zip | 22030-2505
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Country | US
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Telephone | 793-657-9721
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Fax | 703-591-2563
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Provider Business Mailing Address
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Address Line | 10379B DEMOCRACY LN
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City | FAIRFAX
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State | VA
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Zip | 22030-2505
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Country | US
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Telephone | 793-657-9721
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Fax | 703-591-2563
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Authorized Official
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Title or Position | ONE
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Name | MS. MARIANNE S COAD
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Credential | MA
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Telephone | 703-657-9721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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