Provider Demographics
NPI:1962093815
Name:NORTHERN VIRGINIA COUNSELING SERVICES INC.
Entity type:Organization
Organization Name:NORTHERN VIRGINIA COUNSELING SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:DELIA
Authorized Official - Last Name:ENGELKEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,LSATP
Authorized Official - Phone:703-936-8066
Mailing Address - Street 1:10513 JUDICIAL DR STE 201
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7528
Mailing Address - Country:US
Mailing Address - Phone:703-405-9014
Mailing Address - Fax:703-995-4455
Practice Address - Street 1:10513 JUDICIAL DR STE 201
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7528
Practice Address - Country:US
Practice Address - Phone:703-405-9014
Practice Address - Fax:703-995-4455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1215287461Medicaid