Provider Demographics
NPI:1013349232
Name:BURANT, ALYCIA GAYLE (LPC)
Entity type:Individual
Prefix:
First Name:ALYCIA
Middle Name:GAYLE
Last Name:BURANT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ALYCIA
Other - Middle Name:GAYLE
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:950 N WASHINGTON ST
Mailing Address - Street 2:SUITE 322
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-1534
Mailing Address - Country:US
Mailing Address - Phone:703-408-3512
Mailing Address - Fax:
Practice Address - Street 1:950 N WASHINGTON ST
Practice Address - Street 2:SUITE 322
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-1534
Practice Address - Country:US
Practice Address - Phone:703-408-3512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006079101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health