Healthcare Provider Details

I. General information

NPI: 1316728173
Provider Name (Legal Business Name): BARRAT BEHAVIORAL HEALTH AND CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2023
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1549 OLD BRIDGE RD STE 104
WOODBRIDGE VA
22192-2749
US

IV. Provider business mailing address

1549 OLD BRIDGE RD STE 104
WOODBRIDGE VA
22192-2749
US

V. Phone/Fax

Practice location:
  • Phone: 571-543-4880
  • Fax: 571-543-4885
Mailing address:
  • Phone: 571-543-4880
  • Fax: 571-543-4885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KADIJA JALLOH CONTEH-BARRAT
Title or Position: PRACTICE OWNER
Credential: NP
Phone: 571-543-4880