Brian D Anderson

Individual provider Active NPI Professional Counselor · Fairfax, VA

NPI 1073051629 · NPPES record last updated Feb 3, 2017

Key facts

NPI
1073051629
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
0701006894 (VA)
Practice address
8221 Willow Oaks Corporate Dr
Suite 4-420
Fairfax, VA 22031-4512
Phone
(703) 289-7560
Fax
(703) 204-9001
NPI assigned
Feb 3, 2017
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0701006894VAMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701006894 VA Yes

Addresses

Primary practice location

8221 Willow Oaks Corporate Dr
Suite 4-420
Fairfax, VA 22031-4512

Mailing address

8221 Willow Oaks Corporate Dr
Suite 4-420
Fairfax, VA 22031-4512
Phone (703) 289-7560

Other providers in Fairfax, VA

All providers in Fairfax, VA · Professional Counselor in Virginia

Sources for this page

Verify at the official NPI Registry.