Organization Name: | GROUP THERAPY ASSOCIATES |
NPI Number: | 1215163506 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ESTHER BOYKIN (LMFT/CO-OWNER) |
Mailing Address: | 15175 Washington St Suite 302a Haymarket |
State: | VA US |
Postal Code: | 201692951 |
Phone Number: | 7036448041 |
Fax Number: | 7036448041 |
NPI Enumeration Date: | 06/01/2009 |
NPI Last Update Date: | 04/09/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 1104938612 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |