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General NPI Number Information
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NPI Number | 1114543253
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH CENTER OF AMERICA
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Dates
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Enumeration Date | 06/24/2020
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Last Update Date | 03/17/2023
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Provider Practice Location Address
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Address Line | 602 PLUM ST SW
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City | VIENNA
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State | VA
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Zip | 22180-6328
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Country | US
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Telephone | 703-310-8563
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Fax | 703-223-4940
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Provider Business Mailing Address
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Address Line | 602 PLUM ST SW
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City | VIENNA
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State | VA
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Zip | 22180-6328
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Country | US
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Telephone | 703-310-8563
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Fax | 703-223-4940
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Authorized Official
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Title or Position | CEO
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Name | MRS. NEDA RAHIMI
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Credential |
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Telephone | 703-310-8563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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