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General NPI Number Information
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NPI Number | 1184416224
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Entity Type | Organization
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Legal Business Name | HIGHER FUNCTIONING BEHAVIORAL HEALTH SERVICES PLLC
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 11166 FAIRFAX BLVD STE 500
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City | FAIRFAX
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State | VA
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Zip | 22030-5017
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Country | US
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Telephone | 571-445-0441
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Fax |
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Provider Business Mailing Address
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Address Line | 11166 FAIRFAX BLVD STE 500
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City | FAIRFAX
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State | VA
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Zip | 22030-5017
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Country | US
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Telephone | 804-971-5976
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. GORDON FIELDS
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Credential |
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Telephone | 804-971-5976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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