ABDELWAHAB ELTAYEB ELSIRAG


Address: 12587 Fair Lakes Cir Ste 303, Fairfax, VA 22033-3822
Phone: 7033098733

ABDELWAHAB ELTAYEB ELSIRAG (NPI# 1487119707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1487119707
Entity Type Individual
Full Name ABDELWAHAB ELTAYEB ELSIRAG
Practice Address 12587 Fair Lakes Cir Ste 303
Fairfax
VA 22033-3822
Practice Telephone 7033098733
Mailing Telephone 7033098733
Enumeration Date 2019-02-01
Last Update Date 2019-02-01
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
Behavioral Health & Social Service Providers

Office Location

Street Address 12587 FAIR LAKES CIR STE 303
City FAIRFAX
State VA
Zip Code 22033-3822

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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

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1558836825 Monica Jongmin Lee Counselor 2850 Hideaway Rd, Fairfax, VA 22031-1331 2018-10-12
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Competitor

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City FAIRFAX
Zip Code 22033

Improve Information

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Dataset Information

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.

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