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General NPI Number Information
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NPI Number | 1588455885
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Entity Type | Organization
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Legal Business Name | TREAT MENTAL HEALTH VIRGINIA LLC
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 9840 MAIN ST STE 202
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City | FAIRFAX
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State | VA
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Zip | 22031-3909
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Country | US
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Telephone | 201-306-5670
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Fax |
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Provider Business Mailing Address
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Address Line | 2915 RED HILL AVE STE A210C
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City | COSTA MESA
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State | CA
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Zip | 92626-7979
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | SOPHIE GOMES
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Credential |
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Telephone | 201-306-5670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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