PROFESSIONAL MANAGEMENT SERVICES LLC NPI 1356720437

NPI Information

NPI: 1356720437
Provider Name: PROFESSIONAL MANAGEMENT SERVICES, LLC

Doing Business As: VIRGINIA ADDICTION MEDICINE

Classification: Family Medicine - 207QA0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
6138 REDWOOD SQUARE CTR
SUITE 204
CENTREVILLE, VA
ZIP 20121
Phone: (703) 229-5453
Get Directions

PROFESSIONAL MANAGEMENT SERVICES, LLC is an addiction medicine family medicine in Centreville, VA. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. PROFESSIONAL MANAGEMENT SERVICES, LLC NPI is 1356720437. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Virginia Addiction Medicine.

The provider's business location address is:

6138 REDWOOD SQUARE CTR
SUITE 204
CENTREVILLE, VA
ZIP 20121-264
Phone: (703) 229-5453
Fax: (888) 352-8653

The provider's authorized official is Birgit Gabriele Whyard .
The authorized official title is Director Of Operations and has the following contact phone number (703) 229-5453.

The CLIA number assigned to this NPI record is 49D1098151 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/22/2015 and was last updated on 10/6/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101Y00000X	Counselor		No
2	208D00000X	General Practice		No
3	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
4	171W00000X	Contractor		No
5	207RA0401X	Internal Medicine	Addiction Medicine	No
6	207ZP0105X	Pathology	Clinical Pathology/Laboratory Medicine	No
7	2084A0401X	Psychiatry & Neurology	Addiction Medicine	No
8	2084B0040X	Psychiatry & Neurology	Behavioral Neurology & Neuropsychiatry	No
9	2084P0802X	Psychiatry & Neurology	Addiction Psychiatry	No
10	207QA0401X	Family Medicine	Addiction Medicine	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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