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General NPI Number Information
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NPI Number | 1689132557
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Entity Type | Individual
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Provider Name | LAELI SHARIFI WILSON LCP
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Gender | Female
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Dates
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Enumeration Date | 03/08/2019
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 116 W PICCADILLY ST STE 8
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City | WINCHESTER
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State | VA
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Zip | 22601-3965
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Country | US
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Telephone | 703-810-3859
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Fax | 703-804-7420
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Provider Business Mailing Address
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Address Line | 116 W PICCADILLY ST STE 8
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City | WINCHESTER
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State | VA
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Zip | 22601-3965
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Country | US
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Telephone | 703-810-3859
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Fax | 703-804-7420
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810008217
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License Number State | VA
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