MYLISA L ICKES


Address: 7982 Donegan Drive, Manassas, VA 20109
Phone: 5712482358

MYLISA L ICKES (NPI# 1861995060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1861995060
Entity Type Individual
Full Name MYLISA L ICKES
Credential LPC
Practice Address 7982 Donegan Drive
Manassas
VA 20109
Mailing Address 7520 Gardner Park Dr
Gainesville
VA 20155-3414
Practice Telephone 5712482358
Mailing Telephone 5712482358
Enumeration Date 2018-03-14
Last Update Date 2018-03-17
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YP2500X Counselor
Specialization: Professional
0701007547 VA Behavioral Health & Social Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
7520 Gardner Park Dr, Gainesville, VA 201553414 5712482358

Office Location

Street Address 7982 DONEGAN DRIVE
City MANASSAS
State VA
Zip Code 20109

Providers in the same location

NPI Name Taxonomy Address Enumeration
1063979151 Gia Thi Social Worker 7982 Donegan Drive, Manassas, VA 20109 2019-02-25

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1275151854 Laura Zabel Social Worker 10220 Launch Circle #103, Manassas, VA 20109 2020-07-09
1659910677 Leigh Cristi Babin-adkins Registered Nurse 10550 Linden Lake Plazza, Manassas, VA 20109 2019-12-23
1326686221 Sophie Louise Elliot Speech-Language Pathologist 10550 Linden Lake Plaza Suite 100, Manassas, VA 20109 2019-12-11
1962978221 Dominique Marie Cytryn Behavior Technician Family Insight, P.C., 7730 Donegan Dr, Manassas, VA 20109 2018-10-15
1255829008 Lyusyena Teper Physical Therapist 11662 Sudley Manor Dr Ste 50-b, Manassas, VA 20109 2018-04-27
1336641885 Stephanie Joanne Gamboa Behavior Technician 1037 Battleview Pkwy, Manassas, VA 20109 2018-03-01
1154822237 Katherine Sholl Behavior Technician 10370 Battleview Parkway, Manassas, VA 20109 2018-02-23
1386168615 Northern Virginia Checker Cab LLC Taxi 7631 Coppermine Dr, Manassas, VA 20109 2017-07-28
1407383201 Monique Lowery Social Worker 7403 Emerald Dr., Manassas, VA 20109 2017-05-11
1265818363 Good Choi's Dental Care, P.C. Dentist 10555 Crestwood Dr., Unit B, Manassas, VA 20109 2015-07-31
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Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1861038705 Dwight Postell Vick Counselor 9401 Centreville Rd Ste 201, Manassas, VA 20110-5155 2019-11-26
1033769922 Talako Industries Counselor 8711 Plantation Ln Ste 301, Manassas, VA 20110-8322 2019-09-12
1518528884 Sarah Jane Clarius Counselor Prince William County Community Services Board, 7969 Ashton Ave, Manassas, VA 20109-2885 2019-06-26
1104339803 June L. Toth, Inc. Counselor 9720 Capital Court, Suite 303, Manassas, VA 20110-2051 2017-11-16
1376074476 Counseling 1-2-1 LLC Counselor 9200 Church St, 202, Manassas, VA 20110-5597 2017-03-21
1639619174 Andrew Harar Counselor 9203 Acer Ln, Manassas, VA 20110-8916 2017-03-02
1386182236 Katherine Michele Perez Counselor 9720 Capital Ct Ste 302, Manassas, VA 20110-2051 2017-02-10
1851845705 Carrie E Collier Counselor 8361 Mineral Springs Dr, Manassas, VA 20112-2420 2016-08-09
1306296660 Sandra-joy Gray Counselor 7331 Sheraton Dr, Manassas, VA 20112-3678 2016-06-17
1639447220 Amber Cox Counselor 9274 Corporate Cir, Manassas, VA 20110-4153 2011-12-09
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Competitor

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City MANASSAS
Zip Code 20109

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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