| Behavioral Momentum, Llc | |
|
574 Edmonton Ter Ne Leesburg VA 20176-1829 | |
| (443) 540-0120 | |
| Not Available |
| Full Name | Behavioral Momentum, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 574 Edmonton Ter Ne, Leesburg, Virginia |
| Authorized Official Name and Position | Katherine Wilcox (FOUNDER) |
| Authorized Official Contact | 4435400120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Momentum, Llc 574 Edmonton Ter Ne Leesburg VA 20176-1829 Ph: (443) 540-0120 | Behavioral Momentum, Llc 574 Edmonton Ter Ne Leesburg VA 20176-1829 Ph: (443) 540-0120 |
| NPI Number | 1093264657 |
|---|---|
| Provider Enumeration Date | 09/23/2016 |
| Last Update Date | 09/23/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093264657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 133000306 (Virginia) | Primary |
| 252Y00000X | Early Intervention Provider Agency | 133000306 (Virginia) | Secondary |
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