Provider Demographics
NPI:1033705710
Name:ASHLEY PATRICAN LLC
Entity Type:Organization
Organization Name:ASHLEY PATRICAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:PATRICAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:202-873-4350
Mailing Address - Street 1:4343A RIDGEWOOD CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5308
Mailing Address - Country:US
Mailing Address - Phone:202-873-4350
Mailing Address - Fax:
Practice Address - Street 1:4343A RIDGEWOOD CENTER DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-5308
Practice Address - Country:US
Practice Address - Phone:703-897-8970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty