MEDICARE: SISU MENTAL HEALTH AND WELLNESS PLLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1841122454
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SISU MENTAL HEALTH AND WELLNESS PLLC

Provider Business Mailing Address
First Line	:	12872 HARBOR DR
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22192-2921
Country	:	US
Telephone Number	:	703-454-5362
Fax Number	:

Provider Business Practice Location Address
First Line	:	12872 HARBOR DR
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22192-2921
Country	:	US
Telephone Number	:	703-454-5362
Fax Number	:

Authorized Official
Title or Position	:	MEMBER/MANAGER
Name	:	DR. SABRINA ANN SALEM
Credential	:	DNP, APRN, PMHNP-BC
Telephone Number	:	703-454-5362

Provider Enumeration Date	:	05/30/2026
Last Update Date	:	05/30/2026

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