Provider Demographics
NPI:1033264643
Name:RAYBURN, ANN (ANN RAYBURN MA LPC)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:
Last Name:RAYBURN
Suffix:
Gender:F
Credentials:ANN RAYBURN MA LPC
Other - Prefix:MS
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:RAYBURN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ANN RAYBURN MA LPC
Mailing Address - Street 1:7129 ALGER RD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-2552
Mailing Address - Country:US
Mailing Address - Phone:703-698-9210
Mailing Address - Fax:
Practice Address - Street 1:313 PARK AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3327
Practice Address - Country:US
Practice Address - Phone:703-578-1065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701000560101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health