| Fairfax Family Life Behavioral Health, Llc | |
|
Fairfaxpark Office Plaza 9512 B Lee Highway Fairfax VA 22031 | |
| (703) 652-6007 | |
| (703) 652-6007 |
| Full Name | Fairfax Family Life Behavioral Health, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | Fairfaxpark Office Plaza, Fairfax, Virginia |
| Authorized Official Name and Position | Shah M Nadeem (PSYCHIATRIST) |
| Authorized Official Contact | 7033458108 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfax Family Life Behavioral Health, Llc 2737 Sutton Rd Vienna VA 22181-6107 Ph: (301) 538-9676 | Fairfax Family Life Behavioral Health, Llc Fairfaxpark Office Plaza 9512 B Lee Highway Fairfax VA 22031 Ph: (703) 652-6007 |
| NPI Number | 1669976221 |
|---|---|
| Provider Enumeration Date | 03/20/2018 |
| Last Update Date | 11/21/2023 |
| Certification Date | 11/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669976221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 0101243101 (Virginia) | Primary |
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