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General NPI Number Information
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NPI Number | 1902924061
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Entity Type | Organization
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Legal Business Name | NORTHERN VIRGINIA FAMILY SERVICE
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10455 WHITE GRANITE DR SUITE 100
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City | OAKTON
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State | VA
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Zip | 22124-2764
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Country | US
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Telephone | 703-219-2128
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Fax |
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Provider Business Mailing Address
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Address Line | 10455 WHITE GRANITE DR SUITE 100
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City | OAKTON
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State | VA
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Zip | 22124-2764
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Country | US
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Telephone | 703-219-2128
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MS. CAROL F. BAKER
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Credential | L.C.S.W.
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Telephone | 703-219-2128
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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 | 09400532
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License Number State | VA
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