Individual
MARY JO BETYAK-EISLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, LPC, CSAC
Contact information
Practice address
77 WAGONEERS LN, STAFFORD, VA 22554-8521
(619) 507-7254
Mailing address
77 WAGONEERS LN, STAFFORD, VA 22554-8521
(619) 507-7254
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710102795
VA
101YM0800X
Mental Health Counselor
004087-01
NY
101YP2500X
Professional Counselor
Primary
0701005517
VA
Other
Enumeration date
02/13/2024
Last updated
02/13/2024
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