NPI 1902133218 · live from the CMS NPI Registry
Advantage Therapy Center
Counselor, Professional in Lorton, VA. National Provider Identifier 1902133218, active.
NPI record
| NPI | 1902133218 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Professional 101YP2500X |
| Practice location | 9352 Birchfield Way, Lorton, VA 22079 |
| Practice phone | 703-409-6258 |
| Mailing address | 915 Lafayette Blvd # C, Fredericksburg, VA 22401 |
| Enumerated | November 6, 2009 |
| Last updated | November 6, 2009 |
| Authorized official | Hoang Rodgers, Executive Director |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | 0710000893 (VA) |
| Marriage & Family Therapist | 106H00000X | 0717000800 (VA) |
| Counselor, Professional primary | 101YP2500X | 0717000800 (VA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.