Provider Demographics
NPI:1679533459
Name:BEYOND BEHAVIORS, INC.
Entity Type:Organization
Organization Name:BEYOND BEHAVIORS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:MACKE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:703-658-9300
Mailing Address - Street 1:4208 EVERGREEN LN
Mailing Address - Street 2:SUITE #211
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3235
Mailing Address - Country:US
Mailing Address - Phone:703-658-9300
Mailing Address - Fax:
Practice Address - Street 1:4208 EVERGREEN LN
Practice Address - Street 2:SUITE #211
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3235
Practice Address - Country:US
Practice Address - Phone:703-658-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA22705001101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4947207Medicaid