Provider Demographics
NPI:1477121473
Name:CHESLAK, CAROLINE TERESA (LPC)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:TERESA
Last Name:CHESLAK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BERRYS LNDG
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-3608
Mailing Address - Country:US
Mailing Address - Phone:757-880-4026
Mailing Address - Fax:
Practice Address - Street 1:3033 WILSON BLVD STE 700
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-3868
Practice Address - Country:US
Practice Address - Phone:757-844-6586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010513101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health