Provider Demographics
NPI:1558896423
Name:THE ARC OF LOUDOUN
Entity Type:Organization
Organization Name:THE ARC OF LOUDOUN
Other - Org Name:PAXTON CAMPUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR OF PAXTON ADVANTA
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-777-1939
Mailing Address - Street 1:601 CATOCTIN CIR NE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-4964
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 CATOCTIN CIR NE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-4964
Practice Address - Country:US
Practice Address - Phone:703-777-1939
Practice Address - Fax:703-777-1935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty