Healthcare Provider Details

I. General information

NPI: 1215849682
Provider Name (Legal Business Name): VIRGINIA ADDICTION & MENTAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 SHAWNEE RD STE 302
ALEXANDRIA VA
22312-2300
US

IV. Provider business mailing address

5400 SHAWNEE RD STE 302
ALEXANDRIA VA
22312-2300
US

V. Phone/Fax

Practice location:
  • Phone: 571-586-2883
  • Fax: 610-300-3523
Mailing address:
  • Phone: 571-586-2883
  • Fax: 610-300-3523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BRANDT NORTON
Title or Position: CEO
Credential:
Phone: 484-431-6404