Healthcare Provider Details

I. General information

NPI: 1366351025
Provider Name (Legal Business Name): INCLUSIVE BEHAVIORAL HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11166 FAIRFAX BLVD STE 401
FAIRFAX VA
22030-5017
US

IV. Provider business mailing address

11166 FAIRFAX BLVD STE 401
FAIRFAX VA
22030-5017
US

V. Phone/Fax

Practice location:
  • Phone: 703-505-1251
  • Fax: 703-552-4496
Mailing address:
  • Phone: 703-505-1251
  • Fax: 703-552-4496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: PARTAM MANALAI
Title or Position: CEO
Credential: MD
Phone: 202-489-4665