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General NPI Number Information
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NPI Number | 1821589714
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Entity Type | Organization
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Legal Business Name | HEADQUARTERS THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 05/25/2018
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Last Update Date | 05/25/2018
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Provider Practice Location Address
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Address Line | 7001 HERITAGE VILLAGE PLZ STE 125
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City | GAINESVILLE
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State | VA
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Zip | 20155-3095
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Country | US
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Telephone | 571-383-0200
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Fax | 571-421-2696
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Provider Business Mailing Address
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Address Line | 7001 HERITAGE VILLAGE PLZ STE 125
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City | GAINESVILLE
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State | VA
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Zip | 20155-3095
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Country | US
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Telephone | 571-383-0200
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Fax | 571-421-2696
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MONICA CHWOJDAK
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Credential | LPC
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Telephone | 571-229-0316
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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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