Provider Demographics
NPI:1386937829
Name:CYCLELOGICAL CONNECTION INC
Entity type:Organization
Organization Name:CYCLELOGICAL CONNECTION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:PITI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:571-248-0757
Mailing Address - Street 1:42979 GOLF VIEW DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-2006
Mailing Address - Country:US
Mailing Address - Phone:301-706-0996
Mailing Address - Fax:571-248-0758
Practice Address - Street 1:42979 GOLF VIEW DR
Practice Address - Street 2:SUITE 201
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152-2006
Practice Address - Country:US
Practice Address - Phone:301-706-0996
Practice Address - Fax:571-248-0758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004053251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management