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General NPI Number Information
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NPI Number | 1992287114
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Entity Type | Individual
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Provider Name | ELLEN SKOGSBERG LPC
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Gender | Female
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Dates
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Enumeration Date | 09/04/2018
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Last Update Date | 10/15/2023
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Provider Practice Location Address
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Address Line | 21155 WHITFIELD PL STE 202
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City | STERLING
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State | VA
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Zip | 20165-7277
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Country | US
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Telephone | 571-375-0668
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Fax | 703-687-3622
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Provider Business Mailing Address
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Address Line | 21050 LOWRY PARK TER APT 203
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City | ASHBURN
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State | VA
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Zip | 20147-6431
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Country | US
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Telephone | 540-449-1490
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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 | 0701007834
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License Number State | VA
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