MEDICARE: T MED BEHAVIORAL INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	101YP2500X	Professional Counselor
3	2084P0800X	Psychiatry Physician
4	103TC0700X	Clinical Psychologist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DE7999	OTHER	IL	RR MEDICARE 99 IL
3	DE8053	OTHER	IL	RR MEDICARE 16 ILL
5	C19816	OTHER	MD	RRMEDICARE MCARE
6	DF3257	OTHER	IA	RR MEDICARE IOWA
7	CD3552	OTHER	VA	RR MEDICARE VCARE
8	CG3517	OTHER	DC	RR MEDICARE XCARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BM60T	OTHER	MD	BCBS
4	G396	OTHER	MD	BCBS CAREFIRST

General Provider Information

NPI Number	:	1497719272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	T MED BEHAVIORAL INC

Provider Business Mailing Address
First Line	:	5610A SANDY LEWIS DR
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22032-4034
Country	:	US
Telephone Number	:	703-425-8269
Fax Number	:	703-425-6020

Provider Business Practice Location Address
First Line	:	5610A SANDY LEWIS DR
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22032-4034
Country	:	US
Telephone Number	:	703-425-8269
Fax Number	:	703-425-6020

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. ZEE L. FRIEDMAN
Credential	:
Telephone Number	:	703-425-8269

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	03/03/2008

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Directions to “T MED BEHAVIORAL INC ” Practice Location

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