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General NPI Number Information
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NPI Number | 1275646549
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Entity Type | Organization
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Legal Business Name | NORTHERN VIRGINIA MENTAL HEALTH INSTITUTE
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 3302 GALLOWS RD
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City | FALLS CHURCH
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State | VA
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Zip | 22042-3353
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Country | US
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Telephone | 703-207-7158
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Fax | 703-207-7139
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Provider Business Mailing Address
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Address Line | 3302 GALLOWS ROAD
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City | FALLS CHURCH
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State | VA
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Zip | 22042-3398
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Country | US
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Telephone | 703-207-7158
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Fax | 703-207-7139
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Authorized Official
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Title or Position | HIM DIRECTOR/PRIVACY/FOIA OFFICER
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Name | MRS. SHEILA A COVERSON
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Credential | BS, RHIT
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Telephone | 703-207-7158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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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 | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | VA STATE FACILITY
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License Number State | VA
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