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General NPI Number Information
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NPI Number | 1053230649
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Entity Type | Individual
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Provider Name | PATRICK TUBBINS
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Gender | Male
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Dates
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Enumeration Date | 07/15/2026
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Last Update Date | 07/15/2026
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Provider Practice Location Address
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Address Line | 5641 BURKE CENTRE PKWY
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City | BURKE
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State | VA
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Zip | 22015-2259
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Country | US
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Telephone | 703-390-1182
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Fax | 844-269-1569
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Provider Business Mailing Address
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Address Line | 5433 CROWS NEST CT
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City | FAIRFAX
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State | VA
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Zip | 22032-3302
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Country | US
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Telephone | 504-957-4670
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 07001006582
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License Number State | VA
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