| Custom Addiction Recovery Anonymous, Llc | |
|
6951 Duncraig Court Mclean VA 22101 | |
| (571) 499-0626 | |
| Not Available |
| Full Name | Custom Addiction Recovery Anonymous, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 6951 Duncraig Court, Mclean, Virginia |
| Authorized Official Name and Position | Laura D Simon-sulzer (CEO) |
| Authorized Official Contact | 5714990626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Custom Addiction Recovery Anonymous, Llc 6951 Duncraig Court Mclean VA 22101 Ph: (571) 499-0626 | Custom Addiction Recovery Anonymous, Llc 6951 Duncraig Court Mclean VA 22101 Ph: (571) 499-0626 |
| NPI Number | 1659770923 |
|---|---|
| Provider Enumeration Date | 08/22/2014 |
| Last Update Date | 08/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659770923 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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