Individual
MRS. CAROL VANESSA LEIVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
12212 ATHERTON DR, SILVER SPRING, MD 20902-1006
(202) 316-6937
Mailing address
12212 ATHERTON DR, SILVER SPRING, MD 20902-1006
(202) 316-6937
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0701010913
VA
101YP2500X
Professional Counselor
Primary
LC7303
MD
101YP2500X
Professional Counselor
PRC200001560
DC
Other
Enumeration date
11/02/2013
Last updated
06/05/2023
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