Healthcare Provider Details
I. General information
NPI: 1043190325
Provider Name (Legal Business Name): PARENT AND CHILD TREATMENT CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/05/2025
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1737 KING ST STE 330
ALEXANDRIA VA
22314-2760
US
IV. Provider business mailing address
1737 KING ST STE 330
ALEXANDRIA VA
22314-2760
US
V. Phone/Fax
- Phone: 703-662-5212
- Fax:
- Phone: 703-662-5212
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TB0200X |
| Taxonomy | Cognitive & Behavioral Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MEREDITH
WILMER
Title or Position: DIRECTOR
Credential: PHD
Phone: 703-662-5212