Healthcare Provider Details

I. General information

NPI: 1609797455
Provider Name (Legal Business Name): SHARON PSYCHIATRY & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CORPORATE DR STE 301
STAFFORD VA
22554-4889
US

IV. Provider business mailing address

800 CORPORATE DR STE 301
STAFFORD VA
22554-4889
US

V. Phone/Fax

Practice location:
  • Phone: 571-364-0421
  • Fax: 571-417-7119
Mailing address:
  • Phone: 571-364-0421
  • Fax: 571-417-7119

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: SHARON PAYOUWAY
Title or Position: OWNER
Credential: PMHNP
Phone: 571-364-0421