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General NPI Number Information
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NPI Number | 1740749258
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Entity Type | Organization
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Legal Business Name | SUNSTONE COUNSELING, PLLC
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Dates
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Enumeration Date | 03/14/2019
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 124 E BROAD ST
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City | FALLS CHURCH
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State | VA
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Zip | 22046-4529
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Country | US
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Telephone | 703-328-4112
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Fax |
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Provider Business Mailing Address
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Address Line | 124 E BROAD ST STE D
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City | FALLS CHURCH
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State | VA
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Zip | 22046-4530
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Country | US
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Telephone | 703-328-4112
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MR. GEORGE KERMIT COYNE III
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Credential | LCSW
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Telephone | 703-328-4112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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