Provider Demographics
NPI:1972135432
Name:SUCHYTA, BRANDY (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:SUCHYTA
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-2309
Mailing Address - Country:US
Mailing Address - Phone:310-498-6058
Mailing Address - Fax:
Practice Address - Street 1:6800 BACKLICK RD STE 300
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-3069
Practice Address - Country:US
Practice Address - Phone:703-310-7436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008907101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional