MEDICARE: THERAPY AND LIFE COUNSELING

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	101YP2500X	Professional Counselor	0701004238	VA

General Provider Information

NPI Number	:	1699182097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPY AND LIFE COUNSELING

Provider Business Mailing Address
First Line	:	14377 HEREFORD RD
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22193-2107
Country	:	US
Telephone Number	:	703-878-6670
Fax Number	:	703-878-3370

Provider Business Practice Location Address
First Line	:	14377 HEREFORD RD
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22193-2107
Country	:	US
Telephone Number	:	703-878-6670
Fax Number	:	703-878-3370

Authorized Official
Title or Position	:	THERAPIST
Name	:	MS. MICHELE LYNN ZWEIBAHMER
Credential	:	LPC
Telephone Number	:	703-878-6670

Provider Enumeration Date	:	07/17/2014
Last Update Date	:	07/17/2014

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Directions to “THERAPY AND LIFE COUNSELING ” Practice Location

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