Brough, Mary Tiernan
Brough, Mary Tiernan is an sole proprietor health care provider with primary practice located at 11333 Sunset Hills Rd , Reston VA 20190-5205. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Brough, Mary Tiernan can be contacted via phone (703) 742-8540.Contact Information
Primary practice address
11333 Sunset Hills Rd
Reston VA 20190-5205
Phone: (703) 742-8540
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 0701001827 | Virginia |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | LCO182 | Maryland |
Profile Details
| NPI number | 1356438071 |
|---|---|
| LBN Legal business name | Brough, Mary Tiernan |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 6th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356438071 | NPPES |
| Virginia | Other | 088958 | BLUE CROSS/BLUE SHIELD |
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