Organization
COUNSELING 1-2-1 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY G HALES LPC (EXECUTIVE DIRECTOR)
(716) 465-1108
Entity
Organization
Contact information
Practice address
9200 CHURCH ST, 202, MANASSAS, VA 20110-5597
(716) 465-1108
Mailing address
9200 CHURCH ST, 202, MANASSAS, VA 20110-5597
(716) 465-1108
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701006204
VA
101YP2500X
Professional Counselor
LC7200
MD
Other
Enumeration date
03/21/2017
Last updated
03/21/2017
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