| Loudoun Adult Counseling Llc | |
|
11611 Hunters Green Ct Reston VA 20191-3505 | |
| (703) 981-4265 | |
| Not Available |
| Full Name | Loudoun Adult Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 11611 Hunters Green Ct, Reston, Virginia |
| Authorized Official Name and Position | Alicea Ardito (OWNER) |
| Authorized Official Contact | 7039814265 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Loudoun Adult Counseling Llc 11611 Hunters Green Ct Reston VA 20191-3505 Ph: () - | Loudoun Adult Counseling Llc 11611 Hunters Green Ct Reston VA 20191-3505 Ph: (703) 981-4265 |
| NPI Number | 1154905297 |
|---|---|
| Provider Enumeration Date | 05/05/2021 |
| Last Update Date | 05/05/2021 |
| Certification Date | 05/05/2021 |
| Medicare PECOS PAC ID | 1557751104 |
|---|---|
| Medicare Enrollment ID | O20211214001377 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154905297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Alicea Ardito |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700409075 PECOS PAC ID: 9638590193 Enrollment ID: I20200609001622 |
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