Healthcare Provider Details

I. General information

NPI: 1831837855
Provider Name (Legal Business Name): HOPEWELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2022
Last Update Date: 05/20/2022
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N WASHINGTON ST STE 304B
FALLS CHURCH VA
22046-3441
US

IV. Provider business mailing address

1069 W BROAD ST STE 804
FALLS CHURCH VA
22046-4610
US

V. Phone/Fax

Practice location:
  • Phone: 703-923-8965
  • Fax:
Mailing address:
  • Phone: 703-662-1763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA SMITH
Title or Position: CEO
Credential:
Phone: 703-923-8965