Occoquan Counseling, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904005064 Issued in VA

Legal business name

OCCOQUAN COUNSELING, LLC

Practice address

12866 Harbor Dr
Woodbridge, VA 22192-2921

Phone

(703) 494-4164

Fax

(703) 563-9304

NPI assigned

Sep 24, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kelly Facciola, LCSWNPI 1598873101

Title

Member/Manager

Phone

(703) 203-7535

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly Facciola, LCSW

  • Clinical Social Worker
  • Woodbridge, VA
  • NPI 1598873101
  Medicare reassignment Care Compare group NPD Authorized official
• Sonya Lynn Bryce, NCC, LSATP, LPC

  • Professional Counselor
  • Gainesville, VA
  • NPI 1649216854
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524787200000",
    "number": "1780834911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12866 HARBOR DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922921",
            "telephone_number": "703-203-7535",
            "fax_number": "703-563-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12866 HARBOR DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922921",
            "telephone_number": "703-494-4164",
            "fax_number": "703-563-9304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCCOQUAN COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2018-04-27",
        "status": "A",
        "authorized_official_last_name": "FACCIOLA",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "703-203-7535",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904005064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela K Obeng, PSYD
• Emmanuel Obeng
• Peter Obeng
• Obioma Health Care Services
• Obose Mental Health Clinic LLC
• Occoquan Family & Cosmetic Dentistry
• Ehidiamen Eromonsele Odia, LCSW-S
• Nana Ama Maku Oduro, FNP-C
• Blessing Azuka Ojuah
• Uchechukwunna G Ojukwu

• Clinical Social Worker in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.