Healthcare Provider Details

I. General information

NPI: 1558415968
Provider Name (Legal Business Name): NATIONAL CAPITAL TREATMENT AND RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 N. QUINCY STREET
ARLINGTON VA
22203
US

IV. Provider business mailing address

200 N GLEBE RD STE 104
ARLINGTON VA
22203-3755
US

V. Phone/Fax

Practice location:
  • Phone: 703-841-0703
  • Fax: 703-243-0975
Mailing address:
  • Phone: 703-841-0703
  • Fax: 703-243-0975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number122
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number122-01-006
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number122-01-007
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number122-01-11
License Number StateVA
# 7
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number122-14-003
License Number StateVA
# 8
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number122-14-001
License Number StateVA
# 9
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 10
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 11
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number122-14-002
License Number StateVA

VIII. Authorized Official

Name: DAVID NICHOLAS
Title or Position: REVENUE CYCLE DIRECTOR
Credential:
Phone: 703-825-8762