Provider Demographics
NPI:1811577687
Name:NEJAT, YASAMAN (LPC)
Entity Type:Individual
Prefix:
First Name:YASAMAN
Middle Name:
Last Name:NEJAT
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:PO BOX 3801
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22103-3801
Mailing Address - Country:US
Mailing Address - Phone:571-762-0355
Mailing Address - Fax:
Practice Address - Street 1:8250 WESTPARK DR APT 358
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-3163
Practice Address - Country:US
Practice Address - Phone:571-762-0355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010359101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health