Provider Demographics
NPI:1285759878
Name:THE ARK COUNSELING CENTER, INC.
Entity type:Organization
Organization Name:THE ARK COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PACE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:703-383-5157
Mailing Address - Street 1:10560 MAIN ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7182
Mailing Address - Country:US
Mailing Address - Phone:703-383-5157
Mailing Address - Fax:703-383-1536
Practice Address - Street 1:10560 MAIN ST
Practice Address - Street 2:SUITE 305
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7182
Practice Address - Country:US
Practice Address - Phone:703-383-5157
Practice Address - Fax:703-383-1536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0605 0016651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty