Healthcare Provider Details

I. General information

NPI: 1407497951
Provider Name (Legal Business Name): CENTER FOR CLINICAL HEALTH SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2019
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8221 WILLOW OAKS CORPORATE DR # VA22031
FAIRFAX VA
22031-4512
US

IV. Provider business mailing address

7777 LEESBURG PIKE STE 307N
FALLS CHURCH VA
22043-2421
US

V. Phone/Fax

Practice location:
  • Phone: 170-353-8320
  • Fax:
Mailing address:
  • Phone: 703-847-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MEHRNUSH MOHEBI
Title or Position: CEO AND PROGRAM DIRECTOR
Credential: EDD, LMHP, LPC
Phone: 703-847-0000