Healthcare Provider Details

I. General information

NPI: 1215701644
Provider Name (Legal Business Name): THE FAITH SOLUTION OF THE DMV
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2023
Last Update Date: 11/07/2023
Certification Date: 11/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22685 THREE NOTCH RD STE 201
CALIFORNIA MD
20619-3152
US

IV. Provider business mailing address

2603 NW 13TH ST # 3111
GAINESVILLE FL
32609-2835
US

V. Phone/Fax

Practice location:
  • Phone: 240-431-0467
  • Fax:
Mailing address:
  • Phone: 240-431-0467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VERONICA LYNN BROWN
Title or Position: DIRECTOR/CEO
Credential:
Phone: 240-431-0467