Healthcare Provider Details

I. General information

NPI: 1750218376
Provider Name (Legal Business Name): MCLEAN PSYCHIATRY & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1319 CASSIA ST
HERNDON VA
20170-2524
US

IV. Provider business mailing address

1319 CASSIA ST
HERNDON VA
20170-2524
US

V. Phone/Fax

Practice location:
  • Phone: 571-568-9849
  • Fax: 571-486-5547
Mailing address:
  • Phone: 571-568-9849
  • Fax: 571-486-5547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ASHLY MCLEAN
Title or Position: OWNER
Credential: PMHNP
Phone: 571-568-9849