Provider Demographics
NPI:1942790951
Name:SEARLE, NICHOLAS EDWARD (MS, LPC)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:EDWARD
Last Name:SEARLE
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25664 LAUGHTER DR
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-2580
Mailing Address - Country:US
Mailing Address - Phone:703-989-3615
Mailing Address - Fax:
Practice Address - Street 1:43130 AMBERWOOD PLZ STE 140
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152
Practice Address - Country:US
Practice Address - Phone:703-348-0030
Practice Address - Fax:703-542-7770
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007630101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional