Provider Demographics
NPI:1962795872
Name:RESTON CENTER FOR LEARNING, LLC
Entity type:Organization
Organization Name:RESTON CENTER FOR LEARNING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDOLF
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-860-2010
Mailing Address - Street 1:12007 SUNRISE VALLEY DR STE 220
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-3446
Mailing Address - Country:US
Mailing Address - Phone:703-860-2010
Mailing Address - Fax:703-860-2016
Practice Address - Street 1:12007 SUNRISE VALLEY DR STE 220
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-3446
Practice Address - Country:US
Practice Address - Phone:703-860-2010
Practice Address - Fax:703-860-2016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003147103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty