MEDICARE: CARRIE ANN PONN

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	0701015586	VA

General Provider Information

NPI Number	:	1821956442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE ANN PONN

Provider Business Mailing Address
First Line	:	8030 WILLIAMS LN
Second Line	:
City	:	WARRENTON
State	:	VA
Zip	:	20186-7670
Country	:	US
Telephone Number	:	703-895-2868
Fax Number	:

Provider Business Practice Location Address
First Line	:	8030 WILLIAMS LN
Second Line	:
City	:	WARRENTON
State	:	VA
Zip	:	20186-7670
Country	:	US
Telephone Number	:	703-895-2868
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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