Provider Demographics
NPI:1134515240
Name:COUNSELING OF ALEXANDRIA, LLC
Entity Type:Organization
Organization Name:COUNSELING OF ALEXANDRIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CANFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:703-650-9195
Mailing Address - Street 1:709 PENDLETON ST STE 203
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-1820
Mailing Address - Country:US
Mailing Address - Phone:703-650-9195
Mailing Address - Fax:815-377-2636
Practice Address - Street 1:709 PENDLETON ST STE 203
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-1820
Practice Address - Country:US
Practice Address - Phone:703-650-9195
Practice Address - Fax:815-377-2636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040077141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty