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General NPI Number Information
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NPI Number | 1376048371
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Entity Type | Organization
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Legal Business Name | UNIFY BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 03/29/2018
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Last Update Date | 04/09/2018
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Provider Practice Location Address
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Address Line | 4601 FAIRFAX DR STE 1200
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City | ARLINGTON
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State | VA
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Zip | 22203-1559
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Country | US
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Telephone | 857-244-1868
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Fax |
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Provider Business Mailing Address
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Address Line | 1405 S FERN ST # 160
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City | ARLINGTON
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State | VA
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Zip | 22202-2810
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Country | US
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Telephone | 857-244-1868
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | DENIZ EMRE
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Credential |
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Telephone | 571-354-6398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0701007209
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 9477
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 9477
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701007209
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License Number State | VA
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