Provider Demographics
NPI:1821834227
Name:DICARLO, STEPHEN SEAN
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:SEAN
Last Name:DICARLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11800 SUNSET HILLS RD UNIT 305
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-4779
Mailing Address - Country:US
Mailing Address - Phone:202-754-1608
Mailing Address - Fax:
Practice Address - Street 1:510 N WASHINGTON ST STE 100
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3537
Practice Address - Country:US
Practice Address - Phone:703-495-3620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-04
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health