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General NPI Number Information
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NPI Number | 1740154830
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Entity Type | Individual
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Provider Name | STEPHANIE BEATRIZ HOGAN
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Gender | Female
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 8134 OLD KEENE MILL RD STE 101
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City | SPRINGFIELD
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State | VA
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Zip | 22152-1849
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Country | US
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Telephone | 571-400-1580
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Fax |
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Provider Business Mailing Address
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Address Line | 6112 LARSTAN DR
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City | ALEXANDRIA
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State | VA
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Zip | 22312-1201
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Country | US
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Telephone | 571-400-1580
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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 | 0701015435
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License Number State | VA
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