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General NPI Number Information
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NPI Number | 1588529119
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Entity Type | Organization
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Legal Business Name | PINKLEAF RELATIONSHIP & MENTAL HEALTH WELLNESS LLC
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Dates
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Enumeration Date | 12/16/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 3060 WILLIAMS DR STE 3001005
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City | FAIRFAX
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State | VA
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Zip | 22031-4667
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Country | US
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Telephone | 571-540-9258
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Fax | 703-936-8319
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Provider Business Mailing Address
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Address Line | 3060 WILLIAMS DR STE 3001005
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City | FAIRFAX
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State | VA
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Zip | 22031-4667
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Country | US
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Telephone | 571-540-9258
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Fax | 703-936-8319
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | ELIZABETH GREENE
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Credential | LPC
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Telephone | 540-840-1593
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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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