Provider Demographics
NPI:1730779141
Name:VAN ANDEL, CHESSA (MA)
Entity type:Individual
Prefix:
First Name:CHESSA
Middle Name:
Last Name:VAN ANDEL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:CHESSA
Other - Middle Name:
Other - Last Name:AREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:904 S HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-2420
Mailing Address - Country:US
Mailing Address - Phone:540-333-1276
Mailing Address - Fax:
Practice Address - Street 1:3025 HAMAKER CT STE 450
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2237
Practice Address - Country:US
Practice Address - Phone:540-333-1276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011893101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional