Healthcare Provider Details

I. General information

NPI: 1720858988
Provider Name (Legal Business Name): SHIFT HAPPENS THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 LEESBURG PIKE # 1054
FALLS CHURCH VA
22041-2301
US

IV. Provider business mailing address

5801 LEESBURG PIKE # 1054
FALLS CHURCH VA
22041-2301
US

V. Phone/Fax

Practice location:
  • Phone: 571-322-6987
  • Fax:
Mailing address:
  • Phone: 571-322-6987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE DONOVAN
Title or Position: OWNER
Credential: LCSW
Phone: 703-577-7946