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General NPI Number Information
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NPI Number | 1356995898
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Entity Type | Individual
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Provider Name | TIKA TROTTER-MASON LPC
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Gender | Female
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Dates
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Enumeration Date | 08/01/2019
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Last Update Date | 12/02/2020
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Provider Practice Location Address
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Address Line | 1900 N BEAUREGARD STREET
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City | ALEXANDRIA
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State | VA
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Zip | 22311
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Country | US
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Telephone | 703-746-6027
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Fax |
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Provider Business Mailing Address
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Address Line | 9829 LAUREL STREET
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City | FAIRFAX
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State | VA
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Zip | 22032
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Country | US
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Telephone | 434-409-7806
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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 | 0701007153
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701007153
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License Number State | VA
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