Organization
GRACE NOVA COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY LUTRELL STEPHENSON MA, LPC (LICENSED MENTAL HEALTH COUNSELOR)
(571) 230-3019
Entity
Organization
Contact information
Practice address
8227 OLD COURTHOUSE RD STE 215, VIENNA, VA 22182-3815
(571) 230-3019
Mailing address
8227 OLD COURTHOUSE RD STE 215, VIENNA, VA 22182-3815
(571) 230-3019
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/29/2019
Last updated
06/11/2019
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