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NPI Code Detail

MEDICARE: MISS ELIZABETH FERNANDEZ LPC

MEDICARE:  MISS ELIZABETH  FERNANDEZ  LPC
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
1101YM0800XMental Health Counselor0701013189VA

General Provider Information

NPI Number : 1740708122
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ELIZABETH FERNANDEZ LPC
Provider Business Mailing Address
First Line : 1821 MICHAEL FARADAY DR STE 202
Second Line :
City : RESTON
State : VA
Zip : 20190-5348
Country : US
Telephone Number : 703-966-5173
Fax Number : 888-501-2627
Provider Business Practice Location Address
First Line : 1821 MICHAEL FARADAY DR STE 202
Second Line :
City : RESTON
State : VA
Zip : 20190-5348
Country : US
Telephone Number : 703-966-5173
Fax Number : 888-501-2627
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2017
Last Update Date : 05/28/2026

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Directions to “ MISS ELIZABETH FERNANDEZ LPC” Practice Location

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