Provider Demographics
NPI:1922046697
Name:BALAKRISHNAN, VILASINI (LCPC)
Entity type:Individual
Prefix:MRS
First Name:VILASINI
Middle Name:
Last Name:BALAKRISHNAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MRS
Other - First Name:VILASINI
Other - Middle Name:
Other - Last Name:BALA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:10604 MEADOWHILL RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1526
Mailing Address - Country:US
Mailing Address - Phone:301-592-1610
Mailing Address - Fax:
Practice Address - Street 1:50 W MONTGOMERY AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4216
Practice Address - Country:US
Practice Address - Phone:301-592-1610
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0879101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional