Organization
PRINCE WILIAM FAMILY COUNSELING, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY KOCH PSYCHOLOGIST (DIRECTOR)
(703) 330-9933
Entity
Organization
Contact information
Practice address
9625 SURVEYOR CT, SUITE 200, MANASSAS, VA 20110-4422
(703) 330-9933
(703) 368-8454
Mailing address
9625 SURVEYOR CT, SUITE 200, MANASSAS, VA 20110-4422
(703) 330-9933
(703) 368-8454
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0904002397
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5411637
—
VA
Enumeration date
12/20/2006
Last updated
08/22/2020
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