Provider Demographics
NPI:1639455272
Name:DCVA COUNSELING PSYCHOTHERAPY LLC
Entity Type:Organization
Organization Name:DCVA COUNSELING PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ISABEL
Authorized Official - Middle Name:BARRANZUELA
Authorized Official - Last Name:KIRK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:703-231-7991
Mailing Address - Street 1:4220 SLEEPY HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2046
Mailing Address - Country:US
Mailing Address - Phone:703-231-7991
Mailing Address - Fax:
Practice Address - Street 1:3801 FAIRFAX DR
Practice Address - Street 2:SUITE 14
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1762
Practice Address - Country:US
Practice Address - Phone:703-231-7991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA070100473261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health