| Potomac Health Services,llc | |
|
611 S Carlin Springs Rd Suite # 501 Arlington VA 22204-1064 | |
| (703) 861-8722 | |
| (571) 366-2056 |
| Full Name | Potomac Health Services,llc |
|---|---|
| Speciality | Counselor |
| Location | 611 S Carlin Springs Rd, Arlington, Virginia |
| Authorized Official Name and Position | Jamuna D Raju (PSYCHAITRIST) |
| Authorized Official Contact | 7038618722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Potomac Health Services,llc 6508 Dearborn Dr Falls Church VA 22044-1115 Ph: (703) 658-8722 | Potomac Health Services,llc 611 S Carlin Springs Rd Suite # 501 Arlington VA 22204-1064 Ph: (703) 861-8722 |
| NPI Number | 1376740449 |
|---|---|
| Provider Enumeration Date | 06/30/2007 |
| Last Update Date | 12/21/2011 |
| Medicare PECOS PAC ID | 0840215380 |
|---|---|
| Medicare Enrollment ID | O20051013000309 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376740449 | NPI | - | NPPES |
| P00359381 | Other | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 0101236470 (Virginia) | Primary |
| Provider Name | Jamuna D Raju |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922290873 PECOS PAC ID: 2961455415 Enrollment ID: I20050224000892 |
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