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General NPI Number Information
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NPI Number | 1952142549
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Entity Type | Organization
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Legal Business Name | HOPE MENTAL HEALTH AND WELLNESS LLC
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 623 EMANCIPATION HWY
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-4437
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Country | US
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Telephone | 571-447-1182
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 SHIELDS TER NE
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City | LEESBURG
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State | VA
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Zip | 20176-6620
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Country | US
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Telephone | 571-447-1182
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC NURSE PRACTITIONER
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Name | AWATIF BAZZI
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Credential | DNP
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Telephone | 571-447-1182
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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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Taxonomy #2
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 364SP0813X
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Taxonomy Name | Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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