360 INNOVATIVE THERAPY LLC NPI 1770178816

NPI Information

NPI: 1770178816
Provider Name: 360 INNOVATIVE THERAPY LLC
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
10304 EATON PL STE 100
FAIRFAX, VA
ZIP 22030
Phone: (571) 575-3767
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360 INNOVATIVE THERAPY LLC is an addiction (substance use disorder) counselor in Fairfax, VA. 360 INNOVATIVE THERAPY LLC NPI is 1770178816. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

10304 EATON PL STE 100
FAIRFAX, VA
ZIP 22030-238
Phone: (571) 575-3767
Fax: (877) 525-1222

The provider's authorized official is Beverly Mcnairy .
The authorized official title is Ceo and has the following contact phone number (571) 575-3767.

The enumeration date for this NPI number is 3/1/2021 and was last updated on 3/1/2021.

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	101YM0800X	Counselor	Mental Health	No
3	101YS0200X	Counselor	School	No
4	101YA0400X	Counselor	Addiction (Substance Use Disorder)	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: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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