MEDICARE: TMS NEUROHEALTH CENTERS, RESTON, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1245638709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TMS NEUROHEALTH CENTERS, RESTON, LLC

Provider Business Mailing Address
First Line	:	12359 SUNRISE VALLEY DR
Second Line	:
City	:	RESTON
State	:	VA
Zip	:	20191-3462
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8405 GREENSBORO DR STE 120
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22102-5106
Country	:	US
Telephone Number	:	703-356-1568
Fax Number	:

Authorized Official
Title or Position	:	REGIONAL MANAGER
Name	:	KELLI CEFALU
Credential	:
Telephone Number	:	571-359-1171

Provider Enumeration Date	:	12/16/2014
Last Update Date	:	12/16/2014

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