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General NPI Number Information
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NPI Number | 1942065768
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Entity Type | Organization
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Legal Business Name | MIND MEADOW COUNSELING LLC
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Dates
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Enumeration Date | 02/20/2024
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 10560 MAIN ST STE 611
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City | FAIRFAX
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State | VA
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Zip | 22030-7182
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Country | US
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Telephone | 703-972-2120
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Fax | 703-972-2891
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Provider Business Mailing Address
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Address Line | 10560 MAIN ST STE 611
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City | FAIRFAX
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State | VA
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Zip | 22030-7114
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Country | US
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Telephone | 703-972-2120
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Fax | 703-972-2891
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Authorized Official
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Title or Position | OPERATIONS
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Name | ZACKARY ALJURIDE
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Credential |
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Telephone | 786-966-5466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 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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