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General NPI Number Information
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NPI Number | 1700844065
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Entity Type | Individual
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Provider Name | THERESA AILEEN SHUART L.P.C, L.M.F.T, M.ED
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Gender | Female
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 216 SCENIC LN
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City | RICH CREEK
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State | VA
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Zip | 24147-9673
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Country | US
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Telephone | 703-677-7545
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Fax |
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Provider Business Mailing Address
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Address Line | 216 SCENIC LN
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City | RICH CREEK
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State | VA
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Zip | 24147-9673
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Country | US
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Telephone | 703-677-7545
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 24115
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 24115
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC6203
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701001796
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 110400
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License Number State | IA
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Taxonomy #6
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LCM540
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License Number State | MD
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Taxonomy #7
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T2220
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License Number State | OR
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Taxonomy #8
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 07100387
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License Number State | VA
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