| Center For Behavioral Health Llc | |
|
13601 Office Pl Ste 201 Woodbridge VA 22192-4213 | |
| (703) 492-8939 | |
| (703) 763-3006 |
| Full Name | Center For Behavioral Health Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 13601 Office Pl Ste 201, Woodbridge, Virginia |
| Authorized Official Name and Position | Husam K Alathari (PARTNER) |
| Authorized Official Contact | 7034925584 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Behavioral Health Llc 13601 Office Pl Ste 201 Woodbridge VA 22192-4213 Ph: (703) 492-2924 | Center For Behavioral Health Llc 13601 Office Pl Ste 201 Woodbridge VA 22192-4213 Ph: (703) 492-8939 |
| NPI Number | 1699135244 |
|---|---|
| Provider Enumeration Date | 02/24/2016 |
| Last Update Date | 09/20/2022 |
| Certification Date | 09/20/2022 |
| Medicare PECOS PAC ID | 9830528900 |
|---|---|
| Medicare Enrollment ID | O20200413000132 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699135244 | NPI | - | NPPES |
| Provider Name | Husam K Alathari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477574549 PECOS PAC ID: 7810048592 Enrollment ID: I20120209000601 |
| Provider Name | Kedest Gebreselassie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265897391 PECOS PAC ID: 0941503932 Enrollment ID: I20160126000557 |
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