Provider Demographics
NPI:1952142549
Name:HOPE MENTAL HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:HOPE MENTAL HEALTH AND WELLNESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:AWATIF
Authorized Official - Middle Name:
Authorized Official - Last Name:BAZZI
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:571-447-1182
Mailing Address - Street 1:1501 SHIELDS TER NE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-6620
Mailing Address - Country:US
Mailing Address - Phone:571-447-1182
Mailing Address - Fax:
Practice Address - Street 1:623 EMANCIPATION HWY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4437
Practice Address - Country:US
Practice Address - Phone:571-447-1182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-05
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No273Y00000XHospital UnitsRehabilitation Unit
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No364SP0813XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, GeropsychiatricGroup - Multi-Specialty