Healthcare Provider Details

I. General information

NPI: 1578427217
Provider Name (Legal Business Name): STARLIGHT BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 ALPINE DR SE
LEESBURG VA
20175-6158
US

IV. Provider business mailing address

210 ALPINE DR SE
LEESBURG VA
20175-6158
US

V. Phone/Fax

Practice location:
  • Phone: 301-523-0693
  • Fax:
Mailing address:
  • Phone: 301-523-0693
  • Fax:

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: MRS. JOSEPHINE J DAKIN-DAVIS
Title or Position: PMHNP
Credential:
Phone: 301-523-0693