Individual
LEA L MOSES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
10520 JUDICIAL DR, FAIRFAX, VA 22030-5115
(703) 383-8500
Mailing address
10520 JUDICIAL DR, FAIRFAX, VA 22030-5115
(703) 383-8500
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
A11449
NC
101YP2500X
Professional Counselor
Primary
0701007422
VA
101YP2500X
Professional Counselor
2286
KS
Other
Enumeration date
03/30/2010
Last updated
06/21/2023
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