MEDICARE: MAYNE COUNSELING SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1184321937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAYNE COUNSELING SERVICES

Provider Business Mailing Address
First Line	:	3600 S GLEBE RD UNIT 513
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22202-2384
Country	:	US
Telephone Number	:	910-405-2553
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 S GLEBE RD UNIT 513
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22202-2384
Country	:	US
Telephone Number	:	910-405-2553
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHABRIA MAYNE
Credential	:
Telephone Number	:	910-405-2553

Provider Enumeration Date	:	02/13/2023
Last Update Date	:	02/14/2023

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Directions to “MAYNE COUNSELING SERVICES ” Practice Location

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