Provider Demographics
NPI:1194867036
Name:LOUDOUN FAMILY & RELATIONSHIP COUNSELING
Entity Type:Organization
Organization Name:LOUDOUN FAMILY & RELATIONSHIP COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:ANNA
Authorized Official - Last Name:BEETON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-771-7555
Mailing Address - Street 1:215 LOUDOUN ST
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20132
Mailing Address - Country:US
Mailing Address - Phone:703-771-7555
Mailing Address - Fax:703-771-7556
Practice Address - Street 1:215 LOUDOUN ST
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20132
Practice Address - Country:US
Practice Address - Phone:703-771-7555
Practice Address - Fax:703-771-7556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA107636Medicare UPIN