Healthcare Provider Details

I. General information

NPI: 1184256513
Provider Name (Legal Business Name): VERITAS BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2020
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2241M TACKETTS MILL DR
WOODBRIDGE VA
22192-3029
US

IV. Provider business mailing address

2241M TACKETTS MILL DR
WOODBRIDGE VA
22192-3029
US

V. Phone/Fax

Practice location:
  • Phone: 571-777-0970
  • Fax: 571-777-0960
Mailing address:
  • Phone: 571-777-0970
  • Fax: 571-777-0960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: JEREMY J MCDANIEL
Title or Position: PRACTICE MANAGER
Credential:
Phone: 571-777-0970