Provider Demographics
NPI:1659907921
Name:MCCRAY-BROWN, NIYA (LPC)
Entity Type:Individual
Prefix:
First Name:NIYA
Middle Name:
Last Name:MCCRAY-BROWN
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 1:16833 FRANCIS WEST LN
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-2109
Mailing Address - Country:US
Mailing Address - Phone:703-399-5104
Mailing Address - Fax:
Practice Address - Street 1:14000 CROWN CT
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-1460
Practice Address - Country:US
Practice Address - Phone:703-310-7349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701009012101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional