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Organization
CUSTOM ADDICTION RECOVERY ANONYMOUS, LLC
Active
Organization
CUSTOM ADDICTION RECOVERY ANONYMOUS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA D SIMON-SULZER MA; CSAC, COACH (CEO)
(571) 499-0626
Entity
Organization
Contact information
Practice address
6951 DUNCRAIG COURT, MCLEAN, VA 22101
(571) 499-0626
Mailing address
6951 DUNCRAIG COURT, MCLEAN, VA 22101
(571) 499-0626
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/22/2014
Last updated
08/22/2014
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