Healthcare Provider Details

I. General information

NPI: 1730046483
Provider Name (Legal Business Name): COVERED DBT & BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1765 GREENSBORO STATION PL FL 9
MC LEAN VA
22102-3472
US

IV. Provider business mailing address

1765 GREENSBORO STATION PL FL 9
MC LEAN VA
22102-3472
US

V. Phone/Fax

Practice location:
  • Phone: 571-477-1611
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOANNA MARINO
Title or Position: DIRECTOR
Credential: PHD
Phone: 571-477-1611