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Organization
GRACE NOVA COUNSELING
Active
Organization
GRACE NOVA COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY LUTRELL STEPHENSON MA, LPC (LICENSED MENTAL HEALTH COUNSELOR)
(571) 230-3019
Entity
Organization
Contact information
Practice address
8227 OLD COURTHOUSE RD STE 215, VIENNA, VA 22182-3815
(571) 230-3019
Mailing address
8227 OLD COURTHOUSE RD STE 215, VIENNA, VA 22182-3815
(571) 230-3019
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/29/2019
Last updated
06/11/2019
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