person
Gayle P Nissen, LCSW
Mental Health Counselor in Reston, Virginia
NPI 1982849782

Gayle P Nissen is a Mental Health Counselor based in Reston, VA and is specialized in Mental Health. Gayle P Nissen practices in Reston, VA and has the professional credentials of LCSW. The NPI Number for Gayle P Nissen is 1982849782 and holds a License No. 0904005220 (Virginia).

The current practice location address for Gayle P Nissen is 1850 Cameron Glen Dr, Reston, VA and can be reached out via phone at 703-481-4011 and via fax at 703-481-1420.

Location: 1850 Cameron Glen Dr, Reston, VA, 20190-3363
person
Provider Profile Details
NPI Number
1982849782
Provider Name
Gayle P Nissen
Credential
LCSW
Provider Entity Type
Individual
Gender
Female
Address
1850 Cameron Glen Dr, Reston, VA, 20190-3363
Phone Number
703-481-4011
Fax Number
703-481-1420
Provider Enumeration Date
12/08/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
99999 05 VA
institution
Provider Business Practice Location Address Details
Address
1850 Cameron Glen Dr
City
State
Zip
20190-3363
Phone Number
703-481-4011
Fax Number
703-481-1420
person
Provider Business Mailing Address Details
Address
1850 Cameron Glen Dr
City
State
Zip
20190-3363
Phone Number
703-481-4011
Fax Number
703-481-1420
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
0904005220 (Virginia)
Definition
Definition to come...
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