Organization
FIDELIS THERAPY, LLC
Active
Organization
FIDELIS THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELEANOR VINCENT EDD, LPC, CSAC (CEO/THERAPIST)
(703) 474-6427
Entity
Organization
Contact information
Practice address
2555 CHAIN BRIDGE RD, VIENNA, VA 22181-5517
(703) 474-6427
Mailing address
11350 RANDOM HILLS RD FL 8, FAIRFAX, VA 22030-6044
(702) 474-6427
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0701006683
VA
Other
Enumeration date
08/22/2017
Last updated
08/22/2017
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