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General NPI Number Information
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NPI Number | 1396842043
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Entity Type | Individual
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Provider Name | TERESA BUCHANAN ANCELLOTTI PHD, LMFT, LPC
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Gender | Female
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Dates
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Enumeration Date | 09/17/2006
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Last Update Date | 02/12/2019
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Provider Practice Location Address
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Address Line | 1769 JAMESTOWN RD. STE. 102 JAMESTOWNE PROFESSIONAL PARK
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City | WILLIAMSBURG
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State | VA
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Zip | 23185
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Country | US
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Telephone | 757-608-8659
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Fax | 757-932-6020
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Provider Business Mailing Address
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Address Line | 1769 JAMESTOWN RD. STE. 102 JAMESTOWNE PROFESSIONAL PARK
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City | WILLIAMSBURG
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State | VA
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Zip | 23185
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Country | US
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Telephone | 757-608-8659
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Fax | 757-932-6020
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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 | 0701002331
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701092331
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0717000232
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License Number State | VA
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