Organization
PSYCHIATRIC & COUNSELING CENTER OF NORTHERN VIRGINIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA L DELAWTER MD (PRESIDENT)
(703) 257-8401
Entity
Organization
Contact information
Practice address
9244 CENTER STREET, MANASSAS, VA 20110-5551
(703) 257-8401
(703) 257-8403
Mailing address
9244 CENTER STREET, MANASSAS, VA 20110-5551
(703) 257-8401
(703) 257-8403
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0600001194
BUSINESS LICENSE
VA
Enumeration date
12/06/2006
Last updated
08/22/2020
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