Mallory Beth Van Fossen, ATR-BC, LCPAT
Art Therapist in Bethesda, MD. Individual provider (NPI-1).
NPI number1124443239
StatusActive
Last updated in NPPESFeb 1, 2025
Details
- NPI
- 1124443239
- Entity type
- Individual (NPI-1)
- Name
- Ms. Mallory Beth Van Fossen
- Credential
- ATR-BC, LCPAT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 26, 2014
- Certification date
- Feb 1, 2025
- Last updated
- Feb 1, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 221700000X | Art Therapist | ATC054 | MD | Yes |
| 101YP2500X | Counselor, Professional | ATC054 | MD | |
| 101YP2500X | Counselor, Professional | PC007489 | PA |
Practice location
8901 Rockville PikeBethesda, MD 20889-4268
Phone 443-340-2871
Mailing address
8901 Rockville PikeBethesda, MD 20889-0001
Phone 443-340-2871
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