| Mclean Neuropsychiatric Treatment Center Llc | |
|
6849 Old Dominion Dr Ste 340 Mc Lean VA 22101-3791 | |
| (408) 663-1429 | |
| (215) 867-6196 |
| Full Name | Mclean Neuropsychiatric Treatment Center Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6849 Old Dominion Dr Ste 340, Mc Lean, Virginia |
| Authorized Official Name and Position | Aazaz Haq (OWNER) |
| Authorized Official Contact | 4086631429 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mclean Neuropsychiatric Treatment Center Llc 6849 Old Dominion Dr Ste 340 Mc Lean VA 22101-3791 Ph: (408) 663-1429 | Mclean Neuropsychiatric Treatment Center Llc 6849 Old Dominion Dr Ste 340 Mc Lean VA 22101-3791 Ph: (408) 663-1429 |
| NPI Number | 1356935597 |
|---|---|
| Provider Enumeration Date | 03/01/2021 |
| Last Update Date | 05/16/2022 |
| Certification Date | 05/16/2022 |
| Medicare PECOS PAC ID | 5496162315 |
|---|---|
| Medicare Enrollment ID | O20210322000353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356935597 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084B0040X | Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry | (* (Not Available)) | Primary |
| Provider Name | Aazaz Ul Haq |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1457589509 PECOS PAC ID: 6608008081 Enrollment ID: I20210322000400 |
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