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NPI Code Detail

MEDICARE: PHILLIPS PROGRAMS

MEDICARE: PHILLIPS PROGRAMS
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
11041C0700XClinical Social Worker1647VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568714624
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHILLIPS PROGRAMS
Provider Business Mailing Address
First Line : 7010 BRADDOCK RD
Second Line :
City : ANNANDALE
State : VA
Zip : 22003-6006
Country : US
Telephone Number : 703-941-8810
Fax Number : 703-658-2378
Provider Business Practice Location Address
First Line : 7010 BRADDOCK RD
Second Line :
City : ANNANDALE
State : VA
Zip : 22003-6006
Country : US
Telephone Number : 703-941-8810
Fax Number : 703-658-2378
Authorized Official
Title or Position : COMPLIANCE AND DATA COORDINATOR
Name : KERRY ROJAS
Credential : MSW
Telephone Number : 703-941-8810
Provider Enumeration Date : 10/12/2012
Last Update Date : 10/12/2012

Similar Medicare Providers

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Practice Location Address:
7010 BRADDOCK RD
ANNANDALE, VA
22003-6006
Practice Phone: 703-941-8810
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1427358902 — MRS. AMY ORLANDO OTR/L
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Practice Fax:
1063751782 — ANGELA CAPPUCCILLI GANNON LCSW
Practice Location Address:
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1134468408 — MRS. EMILY M HOUSE LCSW
Practice Location Address:
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Directions to “PHILLIPS PROGRAMS ” Practice Location

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