MEDICARE: MARIA JOY FLICK FNP-C, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024172264	VA
2	363LF0000X	Family Nurse Practitioner	0024172264	VA

General Provider Information

NPI Number	:	1013307362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA JOY FLICK FNP-C, PMHNP-BC

Provider Business Mailing Address
First Line	:	12872 HARBOR DR
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22192-2921
Country	:	US
Telephone Number	:	540-207-9303
Fax Number	:	540-930-0478

Provider Business Practice Location Address
First Line	:	12872 HARBOR DR
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22192-2921
Country	:	US
Telephone Number	:	540-440-5938
Fax Number	:	540-930-0478

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2015
Last Update Date	:	05/25/2026

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