Individual
LICIANE ALVES MERCADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
8221 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4512
(703) 573-5679
Mailing address
8221 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4512
(703) 573-5679
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
0701011984
VA
101YP2500X
Professional Counselor
Primary
0701011984
VA
Other
Enumeration date
11/28/2022
Last updated
12/06/2023
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