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General NPI Number Information
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NPI Number | 1386531994
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Entity Type | Organization
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Legal Business Name | MIND AND BODY PYSCHIACTRIC AND MEDICAL SERVICES PLLC
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 5510 CHEROKEE AVE STE 300
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City | ALEXANDRIA
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State | VA
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Zip | 22312-2320
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Country | US
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Telephone | 540-358-8809
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Fax | 707-736-7193
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Provider Business Mailing Address
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Address Line | 5510 CHEROKEE AVE STE 300
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City | ALEXANDRIA
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State | VA
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Zip | 22312-2320
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Country | US
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Telephone | 540-358-8809
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Fax | 707-736-7193
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Authorized Official
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Title or Position | OWNER
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Name | ABIGAIL MENSAH
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Credential |
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Telephone | 240-660-6907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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