Individual
MS. MEGAN KAY FAZENBAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
102 HERITAGE WAY NE, SUITE 302, LEESBURG, VA 20176-4544
(703) 771-5100
(703) 777-0170
Mailing address
102 HERITAGE WAY NE, SUITE 302, LEESBURG, VA 20176-4544
(703) 771-5100
(703) 777-0170
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0701004966
VA
101YP2500X
Professional Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
08/23/2007
Last updated
12/13/2010
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