Provider Demographics
NPI:1093116014
Name:GONCALVES, ANA (MA, MS)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:
Last Name:GONCALVES
Suffix:
Gender:F
Credentials:MA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44121 HARRY BYRD HWY STE 240
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5668
Mailing Address - Country:US
Mailing Address - Phone:703-977-2215
Mailing Address - Fax:571-410-0218
Practice Address - Street 1:44121 HARRY BYRD HWY STE 240
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5668
Practice Address - Country:US
Practice Address - Phone:703-977-2215
Practice Address - Fax:571-410-0218
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-09
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007684101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty