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Organization

PHASES THERAPY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KAT DEVEREAUX LPC (LPC)
(540) 416-2850
Entity
Organization

Contact information

Practice address
3330 BOURBON ST STE 112, FREDERICKSBURG, VA 22408-7333
(540) 416-2850
Mailing address
3330 BOURBON ST STE 112, FREDERICKSBURG, VA 22408-7333
(540) 416-2850

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1215513353
NPI TYPE 1
VA
01
VA0701010324
LPC
VA
Enumeration date
09/01/2021
Last updated
10/30/2023
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