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General NPI Number Information
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NPI Number | 1356049365
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Entity Type | Organization
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Legal Business Name | SYMBIOSIS MENTAL HEALTH AND WELLNESS, LLC
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 3950 CHAINBRIDGE RD STE 4
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City | FAIRFAX
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State | VA
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Zip | 22030
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Country | US
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Telephone | 843-290-4389
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Fax |
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Provider Business Mailing Address
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Address Line | 3804 WILSON BLVD # 1138
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City | ARLINGTON
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State | VA
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Zip | 22203-1920
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Country | US
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Telephone | 571-492-4351
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | ADRIENNE TERESE IANNAZZO
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Credential | LPC
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Telephone | 571-492-4351
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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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