| Fairfax-falls Church Community Services Board | |
|
12011 Government Center Parkway Suite 836 Fairfax VA 22035 | |
| (703) 324-7000 | |
| (703) 653-6626 |
| Full Name | Fairfax-falls Church Community Services Board |
|---|---|
| Speciality | Clinic/Center |
| Location | 12011 Government Center Parkway, Fairfax, Virginia |
| Authorized Official Name and Position | Daryl Washington (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7033247000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfax-falls Church Community Services Board 12011 Government Center Parkway Suite 836 Fairfax VA 22035 Ph: (703) 324-7000 | Fairfax-falls Church Community Services Board 12011 Government Center Parkway Suite 836 Fairfax VA 22035 Ph: (703) 324-7000 |
| NPI Number | 1154356244 |
|---|---|
| Provider Enumeration Date | 07/11/2006 |
| Last Update Date | 10/01/2020 |
| Certification Date | 10/01/2020 |
| Medicare PECOS PAC ID | 6002701356 |
|---|---|
| Medicare Enrollment ID | O20040217000340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154356244 | NPI | - | NPPES |
| 222044 | Other | VA | ANTHEM |
| 010200229 | Medicaid | VA | |
| MHSS | Other | VA | AMERIGROUP |
| 004945107 | Medicaid | VA | |
| 010200270 | Medicaid | VA | |
| 5700 | Other | CAREFIRST BCBS NCA | |
| 008743126 | Medicaid | VA | |
| 010200181 | Medicaid | VA | |
| 541705851 | Other | TRICARE |
| Provider Name | Michael A Sherer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558378067 PECOS PAC ID: 7214820935 Enrollment ID: I20040205001218 |
| Provider Name | Philip S Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780608984 PECOS PAC ID: 4284520289 Enrollment ID: I20040226000163 |
| Provider Name | Anil R Hinnaria |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588687263 PECOS PAC ID: 3173514544 Enrollment ID: I20040524000564 |
| Provider Name | Cordelia Nieketien Tawari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194827139 PECOS PAC ID: 0648254359 Enrollment ID: I20040721001596 |
| Provider Name | Kumudini K Attanagoda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891801460 PECOS PAC ID: 8123098464 Enrollment ID: I20040726001375 |
| Provider Name | Donald E Bartlett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912062142 PECOS PAC ID: 0446219059 Enrollment ID: I20041008000613 |
| Provider Name | Ricardo Adrian Rius |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295751907 PECOS PAC ID: 1052203981 Enrollment ID: I20041204000168 |
| Provider Name | Brian H Marvin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861410821 PECOS PAC ID: 0446216170 Enrollment ID: I20041206000008 |
| Provider Name | Debra W Obeirne |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710045414 PECOS PAC ID: 4183674856 Enrollment ID: I20050131000381 |
| Provider Name | James T Thornburgh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043387236 PECOS PAC ID: 0244272201 Enrollment ID: I20050531000919 |
| Provider Name | Jivan S May |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245331107 PECOS PAC ID: 9537102710 Enrollment ID: I20050608000720 |
| Provider Name | Jyoti H Supanekar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902943483 PECOS PAC ID: 0244262251 Enrollment ID: I20050909000624 |
| Provider Name | Khin T Maw |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083725717 PECOS PAC ID: 2466470596 Enrollment ID: I20051108000302 |
| Provider Name | Minh-chau Nguyen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851321491 PECOS PAC ID: 5496774390 Enrollment ID: I20051121000777 |
| Provider Name | Sadia Rahman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962512095 PECOS PAC ID: 1153343439 Enrollment ID: I20051230000069 |
| Provider Name | Rochelle P Jackson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528076668 PECOS PAC ID: 8628091824 Enrollment ID: I20060112000911 |
| Provider Name | Joelle A Macdonald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407936313 PECOS PAC ID: 8729099429 Enrollment ID: I20060509000801 |
| Provider Name | Eileen N Bryceland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225052871 PECOS PAC ID: 2062410483 Enrollment ID: I20061120000319 |
| Provider Name | Arda Kasaci |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043395338 PECOS PAC ID: 7416958921 Enrollment ID: I20070126000122 |
| Provider Name | Robespierre M Del Rio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518980788 PECOS PAC ID: 1456352863 Enrollment ID: I20070129000298 |
| Provider Name | Jennifer A Friend |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609886589 PECOS PAC ID: 0840392189 Enrollment ID: I20070216000479 |
| Provider Name | Judith Montville-white |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831292192 PECOS PAC ID: 9931201019 Enrollment ID: I20070220000349 |
| Provider Name | Marija Petrovic |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225138530 PECOS PAC ID: 9739281700 Enrollment ID: I20070221000488 |
| Provider Name | Huma Khalil |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831175892 PECOS PAC ID: 5193788800 Enrollment ID: I20070501000140 |
| Provider Name | Mary C Chilcutt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124030697 PECOS PAC ID: 9335245174 Enrollment ID: I20070510000523 |
| Provider Name | Kara Evangeline Ditto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114917754 PECOS PAC ID: 9537260872 Enrollment ID: I20070731000120 |
| Provider Name | Robert E Kenney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720194582 PECOS PAC ID: 5991898306 Enrollment ID: I20070830000400 |
| Provider Name | Megan M Oconnor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679587489 PECOS PAC ID: 0042307548 Enrollment ID: I20071031000205 |
| Provider Name | Sharon J Betts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780874024 PECOS PAC ID: 9234226754 Enrollment ID: I20071031000310 |
| Provider Name | Judith Arlene Yoder |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1578744371 PECOS PAC ID: 5496831547 Enrollment ID: I20080328000741 |
| Provider Name | Joan Rockwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932269719 PECOS PAC ID: 9830275874 Enrollment ID: I20080401000174 |
| Provider Name | Rais A Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447432141 PECOS PAC ID: 1355410457 Enrollment ID: I20080515000218 |
| Provider Name | Yasir B Elamin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003945346 PECOS PAC ID: 6608945456 Enrollment ID: I20080520000096 |
| Provider Name | Anna G Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730353061 PECOS PAC ID: 4486722303 Enrollment ID: I20081006000311 |
| Provider Name | Nesly I Hneich |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437313988 PECOS PAC ID: 8224197439 Enrollment ID: I20081103000554 |
| Provider Name | Navdeep K Dhaliwal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952444564 PECOS PAC ID: 5890854012 Enrollment ID: I20081103000625 |
| Provider Name | Aditi Malik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053579540 PECOS PAC ID: 9436211869 Enrollment ID: I20081219000059 |
| Provider Name | Conrad E Dennis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376728824 PECOS PAC ID: 7214092865 Enrollment ID: I20090213000209 |
| Provider Name | Maria Coica |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356470132 PECOS PAC ID: 8224129739 Enrollment ID: I20090220000420 |
| Provider Name | Gayle Nissen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982849782 PECOS PAC ID: 0244396646 Enrollment ID: I20090310000616 |
| Provider Name | Oanh D Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821146663 PECOS PAC ID: 1254498124 Enrollment ID: I20090319000468 |
| Provider Name | Anjuli Jindal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043493372 PECOS PAC ID: 2668522111 Enrollment ID: I20090604000276 |
| Provider Name | Jacqueline L Tyler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871600635 PECOS PAC ID: 0840337572 Enrollment ID: I20091028000532 |
| Provider Name | Alexander S Isaac |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861428054 PECOS PAC ID: 8527019579 Enrollment ID: I20091029000312 |
| Provider Name | Michael A Suppa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114937943 PECOS PAC ID: 1759423445 Enrollment ID: I20100119000224 |
| Provider Name | Sumera Nadeem |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225226152 PECOS PAC ID: 6406922590 Enrollment ID: I20100202000255 |
| Provider Name | James A Steg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316050180 PECOS PAC ID: 1052436813 Enrollment ID: I20100916000719 |
| Provider Name | Erika A. Olander |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396881082 PECOS PAC ID: 1153478383 Enrollment ID: I20100929000840 |
| Provider Name | Ayesha Mian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780851303 PECOS PAC ID: 5092902452 Enrollment ID: I20101210000359 |
| Provider Name | Amberly M Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518112697 PECOS PAC ID: 5092901132 Enrollment ID: I20110104000384 |
| Provider Name | Allyson H Mosher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477571446 PECOS PAC ID: 5395934269 Enrollment ID: I20110107000057 |
| Provider Name | Christopher D Barrows |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467569723 PECOS PAC ID: 6406037688 Enrollment ID: I20110221001007 |
| Provider Name | Ji-hae Park |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740339076 PECOS PAC ID: 0345427290 Enrollment ID: I20110602000384 |
| Provider Name | Corey S Thornton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639469166 PECOS PAC ID: 8527246727 Enrollment ID: I20110616000501 |
| Provider Name | Mary Salehi Boettler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780704197 PECOS PAC ID: 6204856172 Enrollment ID: I20110914000398 |
| Provider Name | Darcy Kipp Kim |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972895829 PECOS PAC ID: 0446421408 Enrollment ID: I20110922000603 |
| Provider Name | Mark G Reeves |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588777296 PECOS PAC ID: 7416861992 Enrollment ID: I20111003000229 |
| Provider Name | John K Wilson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679689897 PECOS PAC ID: 2860665072 Enrollment ID: I20111103000801 |
| Provider Name | Mimi Khine |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891892220 PECOS PAC ID: 6002089059 Enrollment ID: I20111108000094 |
| Provider Name | John M Hand |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346398005 PECOS PAC ID: 7517130503 Enrollment ID: I20111108000552 |
| Provider Name | Antoinette Terese Zappala |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831201797 PECOS PAC ID: 9638342579 Enrollment ID: I20111109000406 |
| Provider Name | Mai -chi T Ha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144316514 PECOS PAC ID: 7517131493 Enrollment ID: I20111111000362 |
| Provider Name | Robert E Ketcham |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982611141 PECOS PAC ID: 5890969422 Enrollment ID: I20111117000256 |
| Provider Name | Kristen E Werner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154341675 PECOS PAC ID: 0648444760 Enrollment ID: I20111129000359 |
| Provider Name | Larry H Pastor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114095981 PECOS PAC ID: 8921272980 Enrollment ID: I20111201000239 |
| Provider Name | Jason B Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699979682 PECOS PAC ID: 7618132077 Enrollment ID: I20120710000302 |
| Provider Name | Navneet Sidhu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194865428 PECOS PAC ID: 6103922091 Enrollment ID: I20120718000113 |
| Provider Name | Allison K Rivera-guernsey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275736043 PECOS PAC ID: 0244496685 Enrollment ID: I20120730000374 |
| Provider Name | Alfred Y Sun |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922279058 PECOS PAC ID: 3274780515 Enrollment ID: I20120822000071 |
| Provider Name | Lara H Weaver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669724456 PECOS PAC ID: 9931350733 Enrollment ID: I20121102000372 |
| Provider Name | Florence Hagan |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1144538992 PECOS PAC ID: 7113168014 Enrollment ID: I20130718000273 |
| Provider Name | Maria S Tsao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336257278 PECOS PAC ID: 1557595915 Enrollment ID: I20131018000339 |
| Provider Name | Sean C Graham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689681900 PECOS PAC ID: 8628290384 Enrollment ID: I20141112001987 |
| Provider Name | Sumerta Manchandani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649613902 PECOS PAC ID: 5890019533 Enrollment ID: I20150209000668 |
| Provider Name | Nicholas J Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912267196 PECOS PAC ID: 4981858248 Enrollment ID: I20150305000432 |
| Provider Name | Sarah E Douglas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952704348 PECOS PAC ID: 7012235963 Enrollment ID: I20150406001390 |
| Provider Name | Lorency Fernando |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740332519 PECOS PAC ID: 9537182043 Enrollment ID: I20150407000420 |
| Provider Name | Kathleen M Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154715910 PECOS PAC ID: 6608196357 Enrollment ID: I20150520000210 |
| Provider Name | Jacqueline Blake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902282684 PECOS PAC ID: 8022325604 Enrollment ID: I20150915000510 |
| Provider Name | Anola Tanga |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336151331 PECOS PAC ID: 4789759978 Enrollment ID: I20150918001702 |
| Provider Name | Jason J Zodda |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114210846 PECOS PAC ID: 4486962495 Enrollment ID: I20150924001463 |
| Provider Name | Gagandeep Khurana |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104261858 PECOS PAC ID: 7517275233 Enrollment ID: I20150930000836 |
| Provider Name | Michele Pia Meloni Barbosa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770699233 PECOS PAC ID: 6800104043 Enrollment ID: I20151007002443 |
| Provider Name | Angela S Amas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033592746 PECOS PAC ID: 5799094785 Enrollment ID: I20151013001971 |
| Provider Name | Mark V Sakran |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922327196 PECOS PAC ID: 4688989460 Enrollment ID: I20151014002185 |
| Provider Name | Annie Le-hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992184758 PECOS PAC ID: 5799094165 Enrollment ID: I20151026001958 |
| Provider Name | Kathryn J Walseman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952628042 PECOS PAC ID: 4183933591 Enrollment ID: I20151027000624 |
| Provider Name | Ademola O Adetunji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477989408 PECOS PAC ID: 1355643305 Enrollment ID: I20160125002777 |
| Provider Name | Barbara F Sheer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043238256 PECOS PAC ID: 0143383471 Enrollment ID: I20160204002139 |
| Provider Name | Harry L Ayling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396924569 PECOS PAC ID: 0244535987 Enrollment ID: I20160218000501 |
| Provider Name | Nga N Nguyen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679818223 PECOS PAC ID: 4385933522 Enrollment ID: I20160511002194 |
| Provider Name | Lindsay A Moazzami |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043679319 PECOS PAC ID: 9931490992 Enrollment ID: I20160622000742 |
| Provider Name | Sahana Karpoor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568894947 PECOS PAC ID: 4183919434 Enrollment ID: I20160825000491 |
| Provider Name | Imran Akram |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053449389 PECOS PAC ID: 9234237124 Enrollment ID: I20161025001256 |
| Provider Name | Tyrone N White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396295903 PECOS PAC ID: 2365726825 Enrollment ID: I20170228001618 |
| Provider Name | Aisha Sabir |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609970631 PECOS PAC ID: 5193000446 Enrollment ID: I20170328002598 |
| Provider Name | Nora M Rowny |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881068294 PECOS PAC ID: 6204112113 Enrollment ID: I20170407000354 |
| Provider Name | Emily T Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205372497 PECOS PAC ID: 1355627175 Enrollment ID: I20170411000174 |
| Provider Name | Shana M Grady |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356638274 PECOS PAC ID: 5698945491 Enrollment ID: I20170711002492 |
| Provider Name | Diana V Mata |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821354242 PECOS PAC ID: 4284907338 Enrollment ID: I20170912000960 |
| Provider Name | Samuel C Achu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518484443 PECOS PAC ID: 1254697048 Enrollment ID: I20171110001732 |
| Provider Name | Victor Maas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861919433 PECOS PAC ID: 8022374776 Enrollment ID: I20171113002118 |
| Provider Name | Rebecca Mello |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528573243 PECOS PAC ID: 2860752425 Enrollment ID: I20180131000668 |
| Provider Name | Afua B Addo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629598289 PECOS PAC ID: 4981954534 Enrollment ID: I20180904000419 |
| Provider Name | Nikkimah P Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770611527 PECOS PAC ID: 7214287168 Enrollment ID: I20180913002601 |
| Provider Name | Hadley A Corcoran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245718386 PECOS PAC ID: 8628328598 Enrollment ID: I20180914000279 |
| Provider Name | Jennifer R Newhard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912177940 PECOS PAC ID: 3173874864 Enrollment ID: I20180919001276 |
| Provider Name | Kimberly S Ragin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780933549 PECOS PAC ID: 8426309501 Enrollment ID: I20180928002695 |
| Provider Name | Jacqueline Washington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730199134 PECOS PAC ID: 9133471212 Enrollment ID: I20181018000723 |
| Provider Name | Brittany Lockley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336675412 PECOS PAC ID: 1850645953 Enrollment ID: I20181108000030 |
| Provider Name | Kathy J Hickman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689738643 PECOS PAC ID: 9830346576 Enrollment ID: I20181120001647 |
| Provider Name | Michelle J Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871061499 PECOS PAC ID: 9133463623 Enrollment ID: I20181211001228 |
| Provider Name | Gelila S Habte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639649148 PECOS PAC ID: 7517203623 Enrollment ID: I20190110002292 |
| Provider Name | Rachel W Girardi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740746783 PECOS PAC ID: 3971843939 Enrollment ID: I20190329000747 |
| Provider Name | Jennifer L Showalter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508257437 PECOS PAC ID: 9133460975 Enrollment ID: I20190404001826 |
| Provider Name | Johanna C Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689238891 PECOS PAC ID: 5294078028 Enrollment ID: I20190520001350 |
| Provider Name | Ariel Silber |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295380848 PECOS PAC ID: 3072843457 Enrollment ID: I20190927000821 |
| Provider Name | Sonia Altaf |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942856794 PECOS PAC ID: 1355671421 Enrollment ID: I20191003000165 |
| Provider Name | Caroline E Roberts |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659766624 PECOS PAC ID: 6305177213 Enrollment ID: I20191008000790 |
| Provider Name | Devon N Cavanaugh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134536469 PECOS PAC ID: 6800228743 Enrollment ID: I20191115000537 |
| Provider Name | Heather A Harper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174165955 PECOS PAC ID: 0547694788 Enrollment ID: I20191223000756 |
| Provider Name | Vanessa P Cheshier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063059582 PECOS PAC ID: 0749615037 Enrollment ID: I20200114002897 |
| Provider Name | Lauren K Nickum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992342984 PECOS PAC ID: 2668809393 Enrollment ID: I20200219000587 |
| Provider Name | Bibiana G Ortiz Levine |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902441645 PECOS PAC ID: 7315374089 Enrollment ID: I20200219002210 |
| Provider Name | Lacy J Jordan White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114408150 PECOS PAC ID: 7315289790 Enrollment ID: I20200423000390 |
| Provider Name | Irina Rasner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356959118 PECOS PAC ID: 3779908025 Enrollment ID: I20200803002335 |
| Provider Name | Kristina Jorden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326688763 PECOS PAC ID: 8527484963 Enrollment ID: I20200812002766 |
| Provider Name | Jaclyn A Parker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942584917 PECOS PAC ID: 7416373741 Enrollment ID: I20200818001617 |
| Provider Name | Vilma G Gaitan Valdizan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407453442 PECOS PAC ID: 5294146643 Enrollment ID: I20201116002877 |
| Provider Name | Jean Y Cowan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730693433 PECOS PAC ID: 7517371107 Enrollment ID: I20210121002154 |
| Provider Name | Louise M.r. Blasius |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821692450 PECOS PAC ID: 4789098252 Enrollment ID: I20210122002687 |
Integrative Psychotherapy Institute Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3615 Chain Bridge Rd Ste I, Fairfax, VA 22030 Phone: 703-385-9667 | |
Cognitive Consults And Technology Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3020 Hamaker Court, Suite 103, Neuropsychology Associates Of Fairfax, Fairfax, VA 22031 Phone: 703-876-0966 Fax: 703-876-1628 | |
U.s. Care, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4031 University Dr, Suite 100, Fairfax, VA 22030 Phone: 888-978-3801 Fax: 888-978-3802 | |
Dk. Elaine Williams, P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3615 Chain Bridge Rd, Suite F, Fairfax, VA 22030 Phone: 703-383-1386 | |
Mzg Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4031 University Dr Ste 100, Fairfax, VA 22030 Phone: 703-375-9871 | |
Mindful Legacy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4229 Jefferson Oaks Cir Apt B, Fairfax, VA 22033 Phone: 703-718-6413 | |
A Center For Adult, Family And Career Counseling Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 10400 Eaton Pl, Suite 110, Fairfax, VA 22030 Phone: 703-346-3032 Fax: 703-691-0187 |