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General NPI Number Information
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NPI Number | 1518612050
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Entity Type | Individual
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Provider Name | CHERYL RENEE PHILLIPS LPC
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Gender | Female
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 2120 WASHINGTON BLVD
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City | ARLINGTON
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State | VA
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Zip | 22204-5718
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Country | US
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Telephone | 170-322-8485
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 DORR AVE APT 525
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City | FAIRFAX
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State | VA
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Zip | 22031-4946
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Country | US
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Telephone | 157-136-1678
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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