Individual provider · Type 1 NPI

Michael Robert Formichella, MS

Mental Health Counselor · Leesburg, VA

NPI number 1386201382 Active

Practice location

102 Heritage Way NE Ste 302
Leesburg, VA 20176-4544

Call (703) 771-5100 Map

Fax (703) 777-0170

Mailing address

102 Heritage Way NE, Suite 302 PO Box 7400
Leesburg, VA 20177-7400

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X0701012019 (VA)

Mental Health Counselor: Definition to come...

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About NPI 1386201382

Michael Robert Formichella, MS's National Provider Identifier is 1386201382, issued on May 24, 2019. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Leesburg, VA. The record was last updated on Dec 19, 2022.