Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Carl Street, LPC

Individual provider Counselor · NPI 1720450943

Carl Street, LPC is a Mental Health Counselor in Bristow, Virginia. Qualified in 2011, 15 years ago. Practices with Youth for Tomorrow New Life Center Inc, a 15-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
15
Licensed in
VA
In the registry since
2015
Specialties on file
2
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

11835 Hazel Circle Dr
Bristow, VA 20136-2180
Phone: (703) 636-5100
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X · Licence 0701005656 (VA)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 0718000249 (VA)

Record details

NPI number1720450943
Entity typeIndividual (Type 1)
GenderMale
Credentials LPC
Sole proprietorYes
NPI enumeratedOctober 27, 2015
Last updated in NPPESOctober 27, 2015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Youth For Tomorrow New Life Center Inc — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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