Kayran Treia Lee, | |
10416 Burke Lake Rd, Fairfax Station, VA 22039-1808 | |
(703) 297-8416 | |
Not Available |
Full Name | Kayran Treia Lee |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 10416 Burke Lake Rd, Fairfax Station, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427781491 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 0701011188 (Virginia) | Primary |
Entity Name | Youth For Tomorrow New Life Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1316118292 PECOS PAC ID: 1951673227 Enrollment ID: O20170822000018 |
Mailing Address | Practice Location Address |
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Kayran Treia Lee, 500 Abberly Dr Apt 302, Stafford, VA 22554-7346 Ph: (570) 994-4645 | Kayran Treia Lee, 10416 Burke Lake Rd, Fairfax Station, VA 22039-1808 Ph: (703) 297-8416 |
Mrs. Christina Maria Schultz, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 8019 Oak Bridge Ln, Fairfax Station, VA 22039 Phone: 571-882-2925 | |
Kord Hall Basnight, RESIDENT IN COUNSELI Counselor Medicare: Not Enrolled in Medicare Practice Location: 9525 Oak Stream Ct, Fairfax Station, VA 22039 Phone: 703-861-6639 | |
Jonathan S Maurer, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 9507 Gauge Dr, Fairfax Station, VA 22039 Phone: 703-677-6879 |