Ayla Vitalia Mendez, MA
Individual provider Active NPI Professional Counselor · Lignum, VA
NPI 1205447166 · NPPES record last updated Aug 13, 2020
Key facts
- NPI
- 1205447166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 0701009793 (VA)
- Practice address
- 23164 Dragoon Rd
Lignum, VA 22726-2036 - Phone
- (540) 399-1926
- NPI assigned
- Aug 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701009793 | VA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childhelp, Inc. | Current |
Accepting new patients |
Locations
23164 Dragoon Rd
Lignum, VA 22726
Phone (540) 399-1926
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701009793 | VA | Yes |
Addresses
Primary practice location
23164 Dragoon Rd
Lignum, VA 22726-2036
Mailing address
2430 Warrenton Rd
Fredericksburg, VA 22406-4836
Phone (540) 322-8883
Other providers in Lignum, VA
- Lindsay Jankowski
- Robin Long
- Amy Loveless
- Nancy C Lynn
- Lisa Stewart McCarton
- Ayo Morries
- Victoria Elaine Rinald
- Dale Schulz
- Gloria Setterlund
- James A Simpson
All providers in Lignum, VA · Professional Counselor in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.