Provider Demographics
NPI:1902267305
Name:METANOIA CHILD AND FAMILY COUNSELING
Entity Type:Organization
Organization Name:METANOIA CHILD AND FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:HESLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, ATR-BC, ATCS
Authorized Official - Phone:703-901-9721
Mailing Address - Street 1:10837 MONTICELLO DR
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-4225
Mailing Address - Country:US
Mailing Address - Phone:703-901-9721
Mailing Address - Fax:
Practice Address - Street 1:10837 MONTICELLO DR
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:VA
Practice Address - Zip Code:22066-4225
Practice Address - Country:US
Practice Address - Phone:703-901-9721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-11
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Multi-Specialty