Provider Demographics
NPI:1396320818
Name:ENLIGHTENMENT THERAPY SERVICES
Entity type:Organization
Organization Name:ENLIGHTENMENT THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDHYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:703-595-2776
Mailing Address - Street 1:10474 ARMSTRONG ST STE 207
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-3648
Mailing Address - Country:US
Mailing Address - Phone:703-595-2776
Mailing Address - Fax:
Practice Address - Street 1:10474 ARMSTRONG ST STE 207
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-3648
Practice Address - Country:US
Practice Address - Phone:703-595-2776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCPRC14895OtherLICENSE PROFESSIONAL COUNSELOR