Individual provider · Type 1 NPI

Kevin Ichaso

Mental Health Counselor · Fairfax, VA

NPI number 1417804170 Active

Practice location

9480 Main St # 1197
Fairfax, VA 22031-4032

Call (703) 509-0618 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X0701016056 (VA)

Mental Health Counselor: Definition to come...

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About NPI 1417804170

Kevin Ichaso's National Provider Identifier is 1417804170, issued on Mar 12, 2026. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Fairfax, VA. The record was last updated on Apr 4, 2026.