Provider Demographics
NPI:1538935689
Name:VANDIVIER, ABIGAIL F (LPC)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:F
Last Name:VANDIVIER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12007 SUNRISE VALLEY DR STE 120
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-3460
Mailing Address - Country:US
Mailing Address - Phone:703-434-9858
Mailing Address - Fax:
Practice Address - Street 1:12007 SUNRISE VALLEY DR STE 120
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-3460
Practice Address - Country:US
Practice Address - Phone:703-522-2089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-29
Last Update Date:2025-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701014251101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health