| NPI | 1497406797 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | NICOLE L CAMMACK Licensed Clinical Psychologist/CEO 703-594-6794  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | 
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health | 
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2022-01-18 | 
| Last Update Date | 2022-01-18 |