Provider Demographics
NPI:1497412936
Name:SUARES, TATYANA (LGPC,NCC)
Entity Type:Individual
Prefix:
First Name:TATYANA
Middle Name:
Last Name:SUARES
Suffix:
Gender:F
Credentials:LGPC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5055 S CHESTERFIELD RD APT 610
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-1061
Mailing Address - Country:US
Mailing Address - Phone:954-604-3971
Mailing Address - Fax:
Practice Address - Street 1:1627 K ST NW STE 400
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1711
Practice Address - Country:US
Practice Address - Phone:202-643-0344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional