Provider Demographics
NPI:1457014110
Name:SOS PSYCHIATRY, LLC
Entity Type:Organization
Organization Name:SOS PSYCHIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:KIRSTEN
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:540-303-2432
Mailing Address - Street 1:105 DELL CT
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-7035
Mailing Address - Country:US
Mailing Address - Phone:540-303-2432
Mailing Address - Fax:
Practice Address - Street 1:119 THE PLAINS RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:VA
Practice Address - Zip Code:20117-2690
Practice Address - Country:US
Practice Address - Phone:540-303-2432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)