Provider Demographics
NPI:1467037127
Name:MDV BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:MDV BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROBBEY
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:703-944-6525
Mailing Address - Street 1:25887 SYCAMORE GROVE PL
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-5814
Mailing Address - Country:US
Mailing Address - Phone:703-944-6525
Mailing Address - Fax:
Practice Address - Street 1:25887 SYCAMORE GROVE PL
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-5814
Practice Address - Country:US
Practice Address - Phone:703-944-6525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty