Organization
LIVING FREE HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIETTA WARDEN R.N., C.C.S.,C.A.C (PRESIDENT)
(703) 750-1292
Entity
Organization
Contact information
Practice address
4306 EVERGREEN LN STE 204, ANNANDALE, VA 22003-3217
(703) 750-1292
(703) 642-0859
Mailing address
4306 EVERGREEN LN STE 204, ANNANDALE, VA 22003-3217
(703) 750-1292
(703) 642-0859
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
149
VA
101YM0800X
Mental Health Counselor
149
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GV6
AETNA
VA
Enumeration date
03/24/2007
Last updated
08/01/2007
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