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General NPI Number Information
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NPI Number | 1992558548
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Entity Type | Individual
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Provider Name | ANDREW READ MORTON RESIDENT COUNSELOR
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Gender | Male
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Dates
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Enumeration Date | 04/11/2024
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Last Update Date | 04/11/2024
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Provider Practice Location Address
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Address Line | 9110 RAILROAD DR STE 310A
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City | MANASSAS PARK
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State | VA
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Zip | 20111-7042
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Country | US
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Telephone | 703-334-2206
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Fax |
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Provider Business Mailing Address
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Address Line | 2018 N MONROE ST
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City | ARLINGTON
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State | VA
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Zip | 22207-3623
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Country | US
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Telephone | 202-436-1967
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0704016052
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License Number State | VA
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