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6225 Brandon Ave Ste 365 Springfield VA 22150-2526 | |
| (571) 642-3433 | |
| (855) 998-8571 |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 6225 Brandon Ave Ste 365, Springfield, Virginia |
| Authorized Official Name and Position | Jeffrey Stevens (OWNER) |
| Authorized Official Contact | 2488246600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 639295 Dept 93394 Cincinnati OH 45263-9295 Ph: (248) 434-6169 | 6225 Brandon Ave Ste 365 Springfield VA 22150-2526 Ph: (571) 642-3433 |
| NPI Number | 1992392724 |
|---|---|
| Provider Enumeration Date | 12/28/2020 |
| Last Update Date | 01/24/2025 |
| Certification Date | 01/24/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992392724 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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