Provider Demographics
NPI:1639414758
Name:HEALTHY MINDS PSYCHIATRY SERVICES
Entity Type:Organization
Organization Name:HEALTHY MINDS PSYCHIATRY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-596-4353
Mailing Address - Street 1:18341 MID OCEAN PL
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-7477
Mailing Address - Country:US
Mailing Address - Phone:703-596-4353
Mailing Address - Fax:703-996-4811
Practice Address - Street 1:18341 MID OCEAN PL
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-7477
Practice Address - Country:US
Practice Address - Phone:703-596-4353
Practice Address - Fax:703-996-4811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-29
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty