Individual
DEEPA PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, CSOTP
Contact information
Practice address
5415 BACKLICK RD # C, SPRINGFIELD, VA 22151-3915
(703) 750-1714
(703) 339-5651
Mailing address
PO BOX 523421, ATTN CARMEN WYMAN, SPRINGFIELD, VA 22152-5421
(703) 339-6471
(703) 339-5651
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0812000610
VA
1041C0700X
Clinical Social Worker
Primary
0904007859
VA
Other
Enumeration date
06/25/2015
Last updated
04/07/2016
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