Provider Demographics
NPI:1407246127
Name:WHANG, PETER (LPC, PBSF)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:WHANG
Suffix:
Gender:M
Credentials:LPC, PBSF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3163 RAMESSES CT
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-4102
Mailing Address - Country:US
Mailing Address - Phone:571-446-7618
Mailing Address - Fax:
Practice Address - Street 1:10805 MAIN ST
Practice Address - Street 2:SUITE 800
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4729
Practice Address - Country:US
Practice Address - Phone:571-446-7618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAPBSF 168103K00000X
VA0701006290101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst