Lifeworks Outreach Services, Inc. | |
4300 Ridgewood Center Dr Unit A Woodbridge VA 22192-5307 | |
(703) 580-7210 | |
(703) 580-7213 |
Full Name | Lifeworks Outreach Services, Inc. |
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Speciality | Counselor - Mental Health |
Location | 4300 Ridgewood Center Dr Unit A, Woodbridge, Virginia |
Authorized Official Name and Position | Maureen Victoria Fannin (CLINICAL DIRECTOR/OWNER) |
Authorized Official Contact | 7035807210 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lifeworks Outreach Services, Inc. 4300 Ridgewood Center Dr Unit A Woodbridge VA 22192-5307 Ph: (703) 580-7210 | Lifeworks Outreach Services, Inc. 4300 Ridgewood Center Dr Unit A Woodbridge VA 22192-5307 Ph: (703) 580-7210 |
NPI Number | 1962789495 |
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Provider Enumeration Date | 11/11/2011 |
Last Update Date | 11/11/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962789495 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 1039-05-001 (Virginia) | Primary |
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