| Living Free Health Services | |
|
4306 Evergreen Ln Ste 204 Annandale VA 22003-3217 | |
| (703) 750-1292 | |
| (703) 642-0859 |
| Full Name | Living Free Health Services |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 4306 Evergreen Ln Ste 204, Annandale, Virginia |
| Authorized Official Name and Position | Marietta Warden (PRESIDENT) |
| Authorized Official Contact | 7037501292 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Free Health Services 4306 Evergreen Ln Ste 204 Annandale VA 22003-3217 Ph: (703) 750-1292 | Living Free Health Services 4306 Evergreen Ln Ste 204 Annandale VA 22003-3217 Ph: (703) 750-1292 |
| NPI Number | 1376660233 |
|---|---|
| Provider Enumeration Date | 03/24/2007 |
| Last Update Date | 08/01/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376660233 | NPI | - | NPPES |
| GV6 | Other | VA | AETNA |
| GV6 | Other | VA | CAREFIRST CAREFIRST BLUE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 149 (Virginia) | Primary |
| 101YM0800X | Counselor - Mental Health | 149 (Virginia) | Secondary |
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