| Mclean Psychiatric Services Llc | |
|
6832 Old Dominion Dr Ste 200 Mc Lean VA 22101-3827 | |
| (703) 336-2406 | |
| Not Available |
| Full Name | Mclean Psychiatric Services Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6832 Old Dominion Dr Ste 200, Mc Lean, Virginia |
| Authorized Official Name and Position | Richard K Kim (MEMBER/MANAGER) |
| Authorized Official Contact | 7033362406 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mclean Psychiatric Services Llc 6832 Old Dominion Dr Ste 200 Mc Lean VA 22101-3827 Ph: (703) 646-7584 | Mclean Psychiatric Services Llc 6832 Old Dominion Dr Ste 200 Mc Lean VA 22101-3827 Ph: (703) 336-2406 |
| NPI Number | 1093194821 |
|---|---|
| Provider Enumeration Date | 05/26/2015 |
| Last Update Date | 06/02/2015 |
| Medicare PECOS PAC ID | 3779864194 |
|---|---|
| Medicare Enrollment ID | O20161227000235 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093194821 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 0101244221 (Virginia) | Primary |
| Provider Name | Richard K Kim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265696983 PECOS PAC ID: 7618031154 Enrollment ID: I20090129000017 |
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