| Alexandria Csb | |
|
720 N Saint Asaph St Fourth Floor Alexandria VA 22314-1912 | |
| (703) 838-6400 | |
| (703) 838-5070 |
| Full Name | Alexandria Csb |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 720 N Saint Asaph St, Alexandria, Virginia |
| Authorized Official Name and Position | Mercedes Wilson Dallas (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 7038386400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alexandria Csb 4906 Sharon Rd Camp Springs MD 20748-2236 Ph: () - | Alexandria Csb 720 N Saint Asaph St Fourth Floor Alexandria VA 22314-1912 Ph: (703) 838-6400 |
| NPI Number | 1457413098 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457413098 | NPI | - | NPPES |
| 008746A25 | Other | VA | MEDICARE |
| 188512 | Other | VA | ANTHEM |
| 0025 | Other | VA | CARE FIRST BCBS |
| 270291 | Other | VA | AMERIGROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0810001425 (Virginia) | Primary |
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