Provider Demographics
NPI:1922846393
Name:LUCCA HOLISTIC COUNSELING LLC
Entity type:Organization
Organization Name:LUCCA HOLISTIC COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCSW-C, LICSW
Authorized Official - Phone:703-718-6740
Mailing Address - Street 1:6505 GRANGE LN UNIT 303
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-5814
Mailing Address - Country:US
Mailing Address - Phone:240-281-4510
Mailing Address - Fax:
Practice Address - Street 1:220 S WASHINGTON ST # 102
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-3626
Practice Address - Country:US
Practice Address - Phone:703-718-6740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty