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Organization
SOULSTICE CLINICAL COUNSELING & PROFESSIONAL DEVELOPMENT
Active
Organization
SOULSTICE CLINICAL COUNSELING & PROFESSIONAL DEVELOPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS BURGIN (DIRECTOR)
(540) 300-2096
Entity
Organization
Contact information
Practice address
300 GARRISONVILLE RD STE 302, STAFFORD, VA 22554-8903
(540) 300-1196
Mailing address
300 GARRISONVILLE RD STE 302, STAFFORD, VA 22554-8903
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/07/2019
Last updated
09/07/2019
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