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General NPI Number Information
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NPI Number | 1043536121
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH RECOVERY PLLC
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 04/14/2010
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Provider Practice Location Address
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Address Line | 7330 B MCWHORTER PLACE
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City | ANNANDALE
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State | VA
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Zip | 22003
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Country | US
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Telephone | 703-887-2475
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Fax | 703-642-6082
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Provider Business Mailing Address
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Address Line | 436 N ARMISTEAD ST APT 101
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City | ALEXANDRIA
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State | VA
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Zip | 22312-3425
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Country | US
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Telephone | 703-354-5104
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | ANNE N COWLEY
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Credential | LCSW
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Telephone | 703-887-2475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904007312
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License Number State | VA
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