ABSOLUTE MENTAL HEALTH CLINIC LLC (NPI# 1366007460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366007460 |
Entity Type | Organization |
Organization Name | ABSOLUTE MENTAL HEALTH CLINIC LLC |
Practice Address |
1303 Florida Ave Woodbridge VA 22191-3620 |
Practice Telephone | 5713982758 |
Mailing Telephone | 5713982758 |
Enumeration Date | 2019-05-03 |
Last Update Date | 2019-05-03 |
Authorized Official Name | MAXIMO DE LA CRUZ (CHIEF DIRECTOR) |
Authorized Official Telephone | 5715720050 |
Authorized Official Credential | QMHP-C-MA |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
VA | CERTIFICATE OF ASSUMED OR FICTITIOUS NAME | 201509030074274 | 01 |
Street Address |
1303 FLORIDA AVE |
City | WOODBRIDGE |
State | VA |
Zip Code | 22191-3620 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043875248 | Maximo De La Cruz | Clinic/Center | 1303 Florida Ave, Woodbridge, VA 22191-3620 | 2019-05-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861021131 | Bailey Orthodontics Pllc | Dentist | 16446 Navigation Drive, Woodbridge, VA 22191 | 2020-04-07 |
1417589326 | Meseret Abate | Registered Nurse | 15608 William Bayliss Ct, Woodbridge, VA 22191 | 2020-02-08 |
1992279327 | Velocity Urgent Care, LLC | Clinic/Center | 16422 Navigation Dr, Woodbridge, VA 22191 | 2019-01-18 |
1821577263 | Maame Gyasiwah Banahene | Registered Nurse | 1812 Featherstone Rd, Woodbridge, VA 22191 | 2018-08-07 |
1235617507 | Yaw P. Baidoo | Nutritionist | 14960 Potomac Heights Pl Apt 503, Woodbridge, VA 22191 | 2018-07-30 |
1477048452 | Anahita Abazari | Optometrist | 14901 Potomac Town Pl, Suite 120, Woodbridge, VA 22191 | 2018-06-22 |
1619490661 | Misti S Gray | Nurse Practitioner | 2296 Optiz Blvd, Suite 440, About Women Ob/gyn, Woodbridge, VA 22191 | 2017-07-21 |
1568991974 | Patrice Whilby | Behavior Technician | 2264 York Drive Apt 302, Woodbridge, VA 22191 | 2017-06-08 |
1508395245 | Maria Theresa Lee | Registered Nurse | 2028b Opitz Blvd # 22191, Woodbridge, VA 22191 | 2017-06-07 |
1861943763 | A1 Home Care, LLC | Home Health | 13928 Jefferson Davis Hwy, Ste # C, Woodbridge, VA 22191 | 2016-10-17 |
Find all providers in zip 22191 |
Taxonomy Code | 261QM0855X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Adolescent and Children Mental Health |
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740691443 | Total Family Solutions, LLC | Clinic/Center | 1 Woodbridge Ctr Ste 440, Woodbridge, NJ 07095-1171 | 2014-05-15 |
1215260492 | G&g Respite Services | Clinic/Center | 2810 Burrough Hill Ln, Woodbridge, VA 22191-5155 | 2009-09-06 |
1043875248 | Maximo De La Cruz | Clinic/Center | 1303 Florida Ave, Woodbridge, VA 22191-3620 | 2019-05-03 |
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---|---|---|---|---|
1194325191 | Second Chance, LLC | Clinic/Center | 315 Hospital Dr Ste 105, Martinsville, VA 24112-1927 | 2020-10-28 |
1407454515 | Always Blossom, LLC | Clinic/Center | 611 W Graham Rd, Richmond, VA 23222-4207 | 2020-10-12 |
1225645377 | Crescent Moon Counseling LLC | Clinic/Center | 8016 Burrundie Dr, Richmond, VA 23225-1972 | 2020-09-23 |
1811512007 | Schwarz Counseling and Coaching | Clinic/Center | 8109 Mechanicsville Turnpike, Suite 1c, Mechanicsville, VA 23111 | 2020-06-12 |
1174146708 | Nova Telemental Health | Clinic/Center | 14012 Willet Way, Gainesville, VA 20155-5915 | 2020-05-18 |
1659993731 | Sandstone Care Virginia, LLC | Clinic/Center | 11415 Isaac Newton Sq S, Reston, VA 20190-5005 | 2020-05-12 |
1306467147 | Shenandoah Creative Counseling for Children and Adolescents | Clinic/Center | 510 W Broad St Ste H, Waynesboro, VA 22980-4548 | 2020-05-04 |
1801449855 | Amazing Counseling LLC | Clinic/Center | 2428 Windy Pines Bnd, Virginia Beach, VA 23456-3954 | 2019-07-18 |
1912468190 | Village Therapeutic Mentoring Services LLC | Clinic/Center | 1 W Cary St, Richmond, VA 23220-5609 | 2019-03-28 |
1801375118 | Clementine Twin Lakes, LLC | Clinic/Center | 13215 Twin Lakes Dr, Clifton, VA 20124-1215 | 2018-08-08 |
Find all providers with the same taxonomy |
City | WOODBRIDGE |
Zip Code | 22191 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.