Provider Demographics
NPI:1821589714
Name:HEADQUARTERS THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:HEADQUARTERS THERAPY SERVICES, LLC
Other - Org Name:MONICA CHWOJDAK, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHWOJDAK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:571-229-0316
Mailing Address - Street 1:7001 HERITAGE VILLAGE PLZ STE 125
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3095
Mailing Address - Country:US
Mailing Address - Phone:571-383-0200
Mailing Address - Fax:571-421-2696
Practice Address - Street 1:7001 HERITAGE VILLAGE PLZ STE 125
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3095
Practice Address - Country:US
Practice Address - Phone:571-383-0200
Practice Address - Fax:571-421-2696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty