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General NPI Number Information
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NPI Number | 1164527859
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Entity Type | Organization
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Legal Business Name | WOMENS CENTER
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 09/16/2023
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Provider Practice Location Address
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Address Line | 8230 OLD COURTHOUSE RD STE 500
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City | VIENNA
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State | VA
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Zip | 22182-3840
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Country | US
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Telephone | 703-281-2657
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Fax |
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Provider Business Mailing Address
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Address Line | 8230 OLD COURTHOUSE RD STE 500
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City | VIENNA
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State | VA
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Zip | 22182-3840
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Country | US
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Telephone | 571-385-0903
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Fax |
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Authorized Official
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Title or Position | V.P.OF HR & ADMINISTRATION
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Name | JIMMIE ROBERSON
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Credential |
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Telephone | 571-385-0903
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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