Healthcare Provider Details

I. General information

NPI: 1538079090
Provider Name (Legal Business Name): TRIO7 HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43799 MIDDLEWAY TER
ASHBURN VA
20147-7050
US

IV. Provider business mailing address

43799 MIDDLEWAY TER
ASHBURN VA
20147-7050
US

V. Phone/Fax

Practice location:
  • Phone: 424-653-0262
  • Fax:
Mailing address:
  • Phone: 424-653-0262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHUKWUMOBI T EMODI
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: PMP, MSC.
Phone: 424-653-0262