Provider Demographics
NPI:1417643818
Name:PLAYWORKS COUNSELING AND WELLNESS
Entity Type:Organization
Organization Name:PLAYWORKS COUNSELING AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SADE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:571-407-2087
Mailing Address - Street 1:10304 EATON PL STE 100
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2221
Mailing Address - Country:US
Mailing Address - Phone:571-407-2087
Mailing Address - Fax:
Practice Address - Street 1:10304 EATON PL STE 100
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2221
Practice Address - Country:US
Practice Address - Phone:571-407-2087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-18
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health