Provider Demographics
NPI:1467543173
Name:PASTORAL COUNSELING OF NORTHERN VIRGINIA
Entity Type:Organization
Organization Name:PASTORAL COUNSELING OF NORTHERN VIRGINIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HULME
Authorized Official - Suffix:
Authorized Official - Credentials:DMIN, AAPC
Authorized Official - Phone:703-449-1944
Mailing Address - Street 1:4094 MAJESTIC LN
Mailing Address - Street 2:#237
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2104
Mailing Address - Country:US
Mailing Address - Phone:703-449-1944
Mailing Address - Fax:703-361-9577
Practice Address - Street 1:8800 SUDLEY RD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4409
Practice Address - Country:US
Practice Address - Phone:703-449-1944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty