Provider Demographics
NPI:1225824964
Name:MIKE VAZZANA LPC LLC
Entity type:Organization
Organization Name:MIKE VAZZANA LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:VAZZANA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:703-249-9883
Mailing Address - Street 1:222 CATOCTIN CIR SE STE 203
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-3730
Mailing Address - Country:US
Mailing Address - Phone:703-249-9883
Mailing Address - Fax:
Practice Address - Street 1:222 CATOCTIN CIR SE STE 203
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-3730
Practice Address - Country:US
Practice Address - Phone:703-249-9883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty