George, Theresa Marie

George, Theresa Marie is an sole proprietor health care provider with primary practice located at 102 Heritage Way Ne Suite 302, Leesburg VA 20176-4544. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. George, Theresa Marie can be contacted via phone (703) 771-5163.

Contact Information

Primary practice address
102 Heritage Way Ne Suite 302 Leesburg VA 20176-4544
Phone: (703) 771-5163
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 0701003264 Virginia
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 0701003264 Virginia

Profile Details

NPI number 1760592612
LBN Legal business name George, Theresa Marie
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 30th, 2006
Last updated Mar 28th, 2013 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760592612 NPPES
Virginia Other 385153 ANTHEM
Virginia Other 540948306 ANTHEM
Virginia Other 293870 ANTHEM

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