Organization
IMEND THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON FERNANDEZ LPC, NCC (DIRECTOR/PRESIDENT)
(571) 470-3266
Entity
Organization
Contact information
Practice address
9020 LORTON STATION BLVD STE 116, LORTON, VA 22079-4750
(571) 470-3266
Mailing address
8362 MIDDLE RUDDINGS DR, LORTON, VA 22079-5023
(703) 568-5647
(703) 493-8385
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124756010
NPI
VA
Enumeration date
03/06/2023
Last updated
03/06/2023
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