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General NPI Number Information
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NPI Number | 1386868677
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Entity Type | Organization
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Legal Business Name | INNER PERSONAL SESSIONS EMOTIONAL HEALTHCARE
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 05/06/2009
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Provider Practice Location Address
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Address Line | 5596 NEDDLETON AVE
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City | WOODBRIDGE
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State | VA
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Zip | 22193-4166
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Country | US
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Telephone | 703-407-5901
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Fax | 703-680-5901
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Provider Business Mailing Address
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Address Line | 5596 NEDDLETON AVE
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City | WOODBRIDGE
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State | VA
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Zip | 22193-4166
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Country | US
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Telephone | 703-407-5901
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Fax | 703-680-5901
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Authorized Official
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Title or Position | SOCIAL WORK CLINICAL DIRECTOR
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Name | MR. MARVIN E. SESSIONS
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Credential | LCSW
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Telephone | 703-583-2991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0904004996
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License Number State | VA
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