Provider Demographics
NPI:1013395219
Name:EXCEPTIONAL FAMILY MEMBER ADVOCATES LLC
Entity Type:Organization
Organization Name:EXCEPTIONAL FAMILY MEMBER ADVOCATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:D
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:MSME, RBT
Authorized Official - Phone:703-895-1665
Mailing Address - Street 1:10302 BRISTOW CENTER DR
Mailing Address - Street 2:SUITE 62
Mailing Address - City:BRISTOW
Mailing Address - State:VA
Mailing Address - Zip Code:20136-2201
Mailing Address - Country:US
Mailing Address - Phone:703-895-1665
Mailing Address - Fax:703-656-4880
Practice Address - Street 1:10302 BRISTOW CENTER DR
Practice Address - Street 2:SUITE 62
Practice Address - City:BRISTOW
Practice Address - State:VA
Practice Address - Zip Code:20136-2201
Practice Address - Country:US
Practice Address - Phone:703-895-1665
Practice Address - Fax:703-656-4880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty