Healthcare Provider Details

I. General information

NPI: 1578489225
Provider Name (Legal Business Name): ABLE INTEGRATED HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1934 OLD GALLOWS RD STE 322
VIENNA VA
22182-4050
US

IV. Provider business mailing address

1934 OLD GALLOWS RD STE 350
VIENNA VA
22182-4050
US

V. Phone/Fax

Practice location:
  • Phone: 703-947-0672
  • Fax: 703-843-9601
Mailing address:
  • Phone: 703-947-0672
  • Fax: 703-843-9601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TAWAKALITU OLANREWAJU
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: DNP, PMHNP, FNP, MBA
Phone: 703-947-0672