Provider Demographics
NPI:1134797970
Name:BEHAVIORAL HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FANGYU
Authorized Official - Middle Name:
Authorized Official - Last Name:QI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C, LCSW, LICSW
Authorized Official - Phone:917-435-7935
Mailing Address - Street 1:13814 BRANHAM CT
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-5200
Mailing Address - Country:US
Mailing Address - Phone:917-435-7935
Mailing Address - Fax:
Practice Address - Street 1:207 PARK AVE STE B3
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4312
Practice Address - Country:US
Practice Address - Phone:917-435-7935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-17
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty