Provider Demographics
NPI:1669507711
Name:NO VIRGINIA INSTITUTE OF PSYCHIATRY
Entity Type:Organization
Organization Name:NO VIRGINIA INSTITUTE OF PSYCHIATRY
Other - Org Name:NORTHERN VIRGINIA INSTITUTE OF PSYCHIATRY
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:FARIDEH
Authorized Official - Middle Name:
Authorized Official - Last Name:REDFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-922-8484
Mailing Address - Street 1:5537 HEMPSTEAD WAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-4021
Mailing Address - Country:US
Mailing Address - Phone:703-922-8484
Mailing Address - Fax:703-354-7825
Practice Address - Street 1:5537 HEMPSTEAD WAY
Practice Address - Street 2:SUITE B
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-4021
Practice Address - Country:US
Practice Address - Phone:703-922-8484
Practice Address - Fax:703-354-7825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101024658261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health