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General NPI Number Information
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NPI Number | 1851627962
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Entity Type | Organization
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Legal Business Name | PINNACLE BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 10/23/2009
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Last Update Date | 01/04/2011
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Provider Practice Location Address
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Address Line | 20915 ASHBURN ROAD SUITE 200
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City | ASHBURN
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State | VA
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Zip | 20147
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Country | US
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Telephone | 703-436-8303
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Fax | 571-918-0056
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Provider Business Mailing Address
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Address Line | 20915 ASHBURN ROAD SUITE 200
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City | ASHBURN
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State | VA
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Zip | 20147
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Country | US
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Telephone | 703-436-8303
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Fax | 571-918-0056
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. KAREN WEISS
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Credential |
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Telephone | 703-436-8303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810004000
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License Number State | VA
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