Healthcare Provider Details

I. General information

NPI: 1528542461
Provider Name (Legal Business Name): HOPEANDWELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2018
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N WASHINGTON ST STE 102
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: 37-923-8965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. VICTORIA CHIALY HANG SMITH
Title or Position: FOUNDER AND CLINICAL DIRECTOR
Credential: PHD
Phone: 703-923-8965