Provider Demographics
NPI:1124044854
Name:GOTTOVI, SHARON L (LPC, LMFT, LSATP)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:L
Last Name:GOTTOVI
Suffix:
Gender:F
Credentials:LPC, LMFT, LSATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14616 STORE HOUSE DR
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-2376
Mailing Address - Country:US
Mailing Address - Phone:703-631-8390
Mailing Address - Fax:703-802-8654
Practice Address - Street 1:3838 CATHEDRAL LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-3602
Practice Address - Country:US
Practice Address - Phone:703-841-2531
Practice Address - Fax:703-841-2752
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000061101YA0400X
VA0701002404101YP2500X
VA0717000098106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist