Provider Demographics
NPI:1730832049
Name:HOMESTEAD ART THERAPY & COUNSELING LLC
Entity type:Organization
Organization Name:HOMESTEAD ART THERAPY & COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELANEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:703-861-1667
Mailing Address - Street 1:15451 EAGLE TAVERN LN
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-3718
Mailing Address - Country:US
Mailing Address - Phone:908-868-4153
Mailing Address - Fax:
Practice Address - Street 1:24240 JAMES MONROE HWY
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-2732
Practice Address - Country:US
Practice Address - Phone:703-861-1667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)