Provider Demographics
NPI:1538473525
Name:PROJECT SAFE
Entity Type:Organization
Organization Name:PROJECT SAFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:MACZYNSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCPC
Authorized Official - Phone:703-201-0826
Mailing Address - Street 1:675 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4109
Mailing Address - Country:US
Mailing Address - Phone:703-505-0440
Mailing Address - Fax:571-431-6323
Practice Address - Street 1:675 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4109
Practice Address - Country:US
Practice Address - Phone:703-505-0440
Practice Address - Fax:571-431-6323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004156101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty