Healthcare Provider Details

I. General information

NPI: 1740942739
Provider Name (Legal Business Name): MEDIHEAL BEHAVIOR HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2021
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2511 BALDWIN CRES NE
WASHINGTON DC
20018-3849
US

IV. Provider business mailing address

2511 BALDWIN CRES NE
WASHINGTON DC
20018-3849
US

V. Phone/Fax

Practice location:
  • Phone: 703-966-4043
  • Fax:
Mailing address:
  • Phone: 703-966-4043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: AMINA ISMAIL OSMAN
Title or Position: OWNER
Credential: PMHNP-BC, FNP-BC
Phone: 703-966-4043