Healthcare Provider Details

I. General information

NPI: 1902544232
Provider Name (Legal Business Name): HOPEPLUSWELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 05/25/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1487 CHAIN BRIDGE RD STE 204
MC LEAN VA
22101-5723
US

IV. Provider business mailing address

921 LEIGH MILL RD
GREAT FALLS VA
22066-2303
US

V. Phone/Fax

Practice location:
  • Phone: 301-910-5041
  • Fax:
Mailing address:
  • Phone: 301-910-5041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. VICTORIA SMITH
Title or Position: PRESIDENT
Credential:
Phone: 301-910-5041