Organization
ATLANTIC COUNSELING GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE VAZZANA LPC (PARTNER)
(703) 665-0949
Entity
Organization
Contact information
Practice address
20925 PROFESSIONAL PLZ STE 230, ASHBURN, VA 20147-3403
(703) 665-0949
(703) 665-7686
Mailing address
20925 PROFESSIONAL PLZ STE 230, ASHBURN, VA 20147-3403
(703) 665-0949
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
Other
Enumeration date
07/16/2013
Last updated
06/04/2019
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