Individual
KELLY ANN MAIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CSAC
Contact information
Practice address
8221 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4512
(571) 595-7549
Mailing address
3215 HALLRAN RD, FALLS CHURCH, VA 22041-2410
(518) 488-4924
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710103519
VA
101YP2500X
Professional Counselor
Primary
0701011118
VA
Other
Enumeration date
01/05/2022
Last updated
11/30/2023
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