Three Leaves Psychological Services Llc | |
11307 Sunset Hills Rd B-4 Reston VA 20190-5278 | |
(213) 344-9008 | |
Not Available |
Full Name | Three Leaves Psychological Services Llc |
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Speciality | Psychologist |
Location | 11307 Sunset Hills Rd, Reston, Virginia |
Authorized Official Name and Position | Emily Dreiling (CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 2133449008 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Three Leaves Psychological Services Llc 25996 Talamore Dr Chantilly VA 20152-1758 Ph: (213) 344-9008 | Three Leaves Psychological Services Llc 11307 Sunset Hills Rd B-4 Reston VA 20190-5278 Ph: (213) 344-9008 |
NPI Number | 1770016461 |
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Provider Enumeration Date | 04/10/2017 |
Last Update Date | 04/10/2017 |
Medicare PECOS PAC ID | 8022386333 |
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Medicare Enrollment ID | O20170609000707 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770016461 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC1900X | Psychologist - Counseling | 0810005362 (Virginia) | Primary |
Provider Name | Emily A Dreiling |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1518222868 PECOS PAC ID: 6305141235 Enrollment ID: I20160301001956 |
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