Loudoun Adult Counseling Llc | |
11611 Hunters Green Ct Reston VA 20191-3505 | |
(703) 981-4265 | |
Not Available |
Full Name | Loudoun Adult Counseling Llc |
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Speciality | Social Worker |
Location | 11611 Hunters Green Ct, Reston, Virginia |
Authorized Official Name and Position | Alicea Ardito (OWNER) |
Authorized Official Contact | 7039814265 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Loudoun Adult Counseling Llc 11611 Hunters Green Ct Reston VA 20191-3505 Ph: () - | Loudoun Adult Counseling Llc 11611 Hunters Green Ct Reston VA 20191-3505 Ph: (703) 981-4265 |
NPI Number | 1154905297 |
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Provider Enumeration Date | 05/05/2021 |
Last Update Date | 05/05/2021 |
Certification Date | 05/05/2021 |
Medicare PECOS PAC ID | 1557751104 |
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Medicare Enrollment ID | O20211214001377 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154905297 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Alicea Ardito |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1700409075 PECOS PAC ID: 9638590193 Enrollment ID: I20200609001622 |
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