| Guiding Light Therapy | |
|
8150 Leesburg Pike Fl 14 Vienna VA 22182-7715 | |
| (703) 395-4445 | |
| Not Available |
| Full Name | Guiding Light Therapy |
|---|---|
| Speciality | Social Worker |
| Location | 8150 Leesburg Pike Fl 14, Vienna, Virginia |
| Authorized Official Name and Position | Susan Perry (OWNER) |
| Authorized Official Contact | 7575853366 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Guiding Light Therapy 4193 Haymarket Ln Williamsburg VA 23188-1466 Ph: (757) 585-3366 | Guiding Light Therapy 8150 Leesburg Pike Fl 14 Vienna VA 22182-7715 Ph: (703) 395-4445 |
| NPI Number | 1407515729 |
|---|---|
| Provider Enumeration Date | 12/14/2021 |
| Last Update Date | 09/20/2022 |
| Certification Date | 09/20/2022 |
| Medicare PECOS PAC ID | 9436543550 |
|---|---|
| Medicare Enrollment ID | O20220304001987 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407515729 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Susan Perry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285810309 PECOS PAC ID: 9234523358 Enrollment ID: I20220325002274 |
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