Healthcare Provider Details

I. General information

NPI: 1649121351
Provider Name (Legal Business Name): SHARON PAYOUWAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2833 CLEAVE DR
FALLS CHURCH VA
22042-2307
US

IV. Provider business mailing address

2120 ABBOTTSBURY WAY
WOODBRIDGE VA
22191-4057
US

V. Phone/Fax

Practice location:
  • Phone: 571-293-2499
  • Fax: 571-351-4815
Mailing address:
  • Phone: 571-290-9707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024196727
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: