Basic Information
| Provider Information | |||||||||
| NPI: | 1487763629 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WHYSONG | ||||||||
| FirstName: | BRETT | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | LPC, NCAC II, CSAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 102 HERITAGE WAY NE SUITE #302 | ||||||||
| Address2: | |||||||||
| City: | LEESBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 20176 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037715100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 102 HERITAGE WAY NE STE 302 | ||||||||
| Address2: | |||||||||
| City: | LEESBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201764544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037715100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 09/07/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 0701003973 | VA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.