Provider Demographics
NPI:1922108612
Name:GRANT, VITTORIA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:VITTORIA
Middle Name:
Last Name:GRANT
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 1:3255 BETSY LN
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:VA
Mailing Address - Zip Code:20171-1615
Mailing Address - Country:US
Mailing Address - Phone:703-383-0673
Mailing Address - Fax:
Practice Address - Street 1:10375 DEMOCRACY LN STE B
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2554
Practice Address - Country:US
Practice Address - Phone:703-383-0673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002956101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health