Organization
PEARL VITALITY COUNSELING
Active
Organization
PEARL VITALITY COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TALIA BRYAN LCSW (THERAPIST/ LCSW)
(757) 358-1771
Entity
Organization
Contact information
Practice address
4809 EISENHOWER AVE STE B, ALEXANDRIA, VA 22304-4832
(757) 358-1771
Mailing address
650 POTOMAC AVE APT 410, ALEXANDRIA, VA 22301-3072
(757) 358-1771
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0904008852
VA
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
0904008852
VA
Other
Enumeration date
01/17/2018
Last updated
01/17/2018
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