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General NPI Number Information
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NPI Number | 1457953283
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Entity Type | Organization
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Legal Business Name | MIND PLAY, LLC
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 14540 JOHN MARSHALL HWY STE 100
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City | GAINESVILLE
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State | VA
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Zip | 20155-1693
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Country | US
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Telephone | 540-216-2285
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Fax | 571-415-3002
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Provider Business Mailing Address
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Address Line | 6479 GOOCHLAND ST
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City | WARRENTON
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State | VA
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Zip | 20187-4175
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Country | US
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Telephone | 937-554-5975
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Fax | 571-415-3002
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Authorized Official
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Title or Position | CEO
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Name | MARY KIRKPATRICK
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Credential | LPC
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Telephone | 937-554-5975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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