NEUROPSYCH WELLNESS CENTER (NPI# 1558764134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558764134 |
| Entity Type | Organization |
| Organization Name | NEUROPSYCH WELLNESS CENTER |
| Practice Address |
3930 Pender Dr Ste 350 Fairfax VA 22030-0989 |
| Mailing Address |
Po Box 220403 Chantilly VA 20153-0403 |
| Practice Telephone | 7038658686 |
| Enumeration Date | 2014-09-26 |
| Last Update Date | 2014-09-26 |
| Authorized Official Name | DR. ALOK KUMAR (PRESIDENT/CEO) |
| Authorized Official Telephone | 7036261420 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407236482 | Neuropsych Wellness Center | Psychiatry & Neurology | 3930 Pender Dr Ste 350, Fairfax, VA 22030-0989 | 2015-06-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | NEUROPSYCH WELLNESS CENTER P.C. | 3930 Pender Drive, Suite 350, Fairfax, Virginia 22030 |
| Street Address |
3930 PENDER DR STE 350 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-0989 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639373202 | Alok Kumar | Psychiatry & Neurology | 3930 Pender Dr Ste 350, Fairfax, VA 22030-0986 | 2007-06-14 |
| 1306309679 | Abebayhu Tekalign | Counselor | 3930 Pender Dr Ste 350, Fairfax, VA 22030-0989 | 2019-04-12 |
| 1376918318 | Wellness Program, LLC | Clinic/Center | 3930 Pender Dr Ste 350, Fairfax, VA 22030-0989 | 2015-12-02 |
| 1407236482 | Neuropsych Wellness Center | Psychiatry & Neurology | 3930 Pender Dr Ste 350, Fairfax, VA 22030-0989 | 2015-06-04 |
| 1902206550 | Christina Webster | Counselor | 3930 Pender Dr Ste 350, Fairfax, VA 22030-0989 | 2014-09-02 |
| 1750641668 | Vikas Mangewala | Psychiatry & Neurology | 3930 Pender Dr Ste 350, Fairfax, VA 22030-0989 | 2012-05-24 |
| 1710272083 | Suzanne Cox | Nurse Practitioner | 3930 Pender Dr Ste 350, Fairfax, VA 22030-0989 | 2011-06-15 |
| 1588977748 | Neuropsych Wellness Center, PC | Psychiatry & Neurology | 3930 Pender Dr Ste 350, Fairfax, VA 22030-0989 | 2010-07-16 |
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|---|---|---|---|---|
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| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
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| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
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| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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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.