Provider Demographics
NPI:1205213659
Name:NOVA COUNSELING AND PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:NOVA COUNSELING AND PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:703-389-1931
Mailing Address - Street 1:13895 HEDGEWOOD DR STE 313
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-7927
Mailing Address - Country:US
Mailing Address - Phone:703-389-1931
Mailing Address - Fax:703-580-4642
Practice Address - Street 1:13895 HEDGEWOOD DR STE 313
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-7927
Practice Address - Country:US
Practice Address - Phone:703-389-1931
Practice Address - Fax:703-580-4642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-05
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty