Provider Demographics
NPI:1285963454
Name:PINERIDGE COUNSELING CENTER
Entity type:Organization
Organization Name:PINERIDGE COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:STRAWT
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:703-849-8414
Mailing Address - Street 1:9477 SILVER KING CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4723
Mailing Address - Country:US
Mailing Address - Phone:703-849-8414
Mailing Address - Fax:703-359-8330
Practice Address - Street 1:9477 SILVER KING CT
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4723
Practice Address - Country:US
Practice Address - Phone:703-849-8414
Practice Address - Fax:703-359-8330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty