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General NPI Number Information
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NPI Number | 1659907921
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Entity Type | Individual
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Provider Name | NIYA MCCRAY-BROWN LPC
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Gender | Female
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Dates
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Enumeration Date | 03/19/2020
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Last Update Date | 03/19/2020
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Provider Practice Location Address
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Address Line | 14000 CROWN CT
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City | WOODBRIDGE
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State | VA
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Zip | 22193-1460
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Country | US
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Telephone | 703-310-7349
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Fax |
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Provider Business Mailing Address
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Address Line | 16833 FRANCIS WEST LN
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City | DUMFRIES
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State | VA
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Zip | 22026-2109
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Country | US
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Telephone | 703-399-5104
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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 | 0701009012
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License Number State | VA
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