| Constellation Counseling Services, Llc | |
|
4129 Dallas Hutchison St Chantilly VA 20151-2944 | |
| (301) 304-8825 | |
| Not Available |
| Full Name | Constellation Counseling Services, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4129 Dallas Hutchison St, Chantilly, Virginia |
| Authorized Official Name and Position | Cortlandt H Mazzotta (OWNER) |
| Authorized Official Contact | 3013048825 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Constellation Counseling Services, Llc 4129 Dallas Hutchison St Chantilly VA 20151-2944 Ph: (301) 304-8825 | Constellation Counseling Services, Llc 4129 Dallas Hutchison St Chantilly VA 20151-2944 Ph: (301) 304-8825 |
| NPI Number | 1437982717 |
|---|---|
| Provider Enumeration Date | 08/22/2024 |
| Last Update Date | 08/22/2024 |
| Certification Date | 08/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437982717 | NPI | - | NPPES |
| 1285193730 | Other | TN | OPTUM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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