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General NPI Number Information
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NPI Number | 1568907749
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Entity Type | Individual
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Provider Name | DIANE MCCARTHY PROST M.ED, NCC, LPC
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Gender | Female
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Dates
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Enumeration Date | 12/27/2016
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 10522 ROSEHAVEN ST APT 214
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City | FAIRFAX
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State | VA
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Zip | 22030-2862
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Country | US
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Telephone | 314-640-1530
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Fax | 636-898-4758
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Provider Business Mailing Address
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Address Line | 10522 ROSEHAVEN ST APT 214
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City | FAIRFAX
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State | VA
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Zip | 22030-2862
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Country | US
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Telephone | 314-640-1530
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Fax | 636-898-4758
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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 | 0701013187
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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 | 2011037455
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License Number State | MO
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