Healthcare Provider Details

I. General information

NPI: 1295393791
Provider Name (Legal Business Name): ALPHA HEALTHCARE SERVICES AND SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2019
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46179 WESTLAKE DR STE 330
STERLING VA
20165-5874
US

IV. Provider business mailing address

10919 BELGRAVIA CT
GREAT FALLS VA
22066-3106
US

V. Phone/Fax

Practice location:
  • Phone: 703-589-9964
  • Fax: 571-252-7100
Mailing address:
  • Phone: 703-589-9964
  • Fax: 571-252-7100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MUBIN JIWANI
Title or Position: MANAGING MEMBER
Credential: RN, CCS, CDIP, CRC
Phone: 703-589-9964