Converge Behavioral Services, Llc | |
11507 Hearthstone Ct Reston VA 20191-4403 | |
(304) 240-9023 | |
Not Available |
Full Name | Converge Behavioral Services, Llc |
---|---|
Speciality | Assistant Behavior Analyst |
Location | 11507 Hearthstone Ct, Reston, Virginia |
Authorized Official Name and Position | Kirsten Bade (PROGRAM CONSULTANT) |
Authorized Official Contact | 3042409023 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Converge Behavioral Services, Llc 11507 Hearthstone Ct Reston VA 20191-4403 Ph: (304) 240-9023 | Converge Behavioral Services, Llc 11507 Hearthstone Ct Reston VA 20191-4403 Ph: (304) 240-9023 |
NPI Number | 1386299071 |
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Provider Enumeration Date | 08/08/2019 |
Last Update Date | 08/08/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386299071 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
106E00000X | Assistant Behavior Analyst | (* (Not Available)) | Primary |
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