Provider Demographics
NPI:1457742694
Name:MOGHADDAM MARAGHEH, NARGESS (LPC)
Entity Type:Individual
Prefix:
First Name:NARGESS
Middle Name:
Last Name:MOGHADDAM MARAGHEH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:NARGESS
Other - Middle Name:
Other - Last Name:MOGHADDAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3801 N. FAIRFAX DRIVE
Mailing Address - Street 2:SUITE 53
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203
Mailing Address - Country:US
Mailing Address - Phone:703-593-5600
Mailing Address - Fax:
Practice Address - Street 1:3801 N. FAIRFAX DRIVE
Practice Address - Street 2:SUITE 53
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203
Practice Address - Country:US
Practice Address - Phone:703-593-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-10
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006049101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional