| Afshar Brothers Inc. | |
|
13655 Dulles Technology Dr Ste 120 Herndon VA 20171-4634 | |
| (571) 665-4025 | |
| (703) 890-2554 |
| Full Name | Afshar Brothers Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 13655 Dulles Technology Dr Ste 120, Herndon, Virginia |
| Authorized Official Name and Position | Stephanie L Afshar (OWNER) |
| Authorized Official Contact | 7038691468 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Afshar Brothers Inc. 13655 Dulles Technology Dr Ste 120 Herndon VA 20171-4634 Ph: (715) 665-4025 | Afshar Brothers Inc. 13655 Dulles Technology Dr Ste 120 Herndon VA 20171-4634 Ph: (571) 665-4025 |
| NPI Number | 1629787809 |
|---|---|
| Provider Enumeration Date | 11/16/2022 |
| Last Update Date | 04/25/2025 |
| Certification Date | 04/25/2025 |
| Medicare PECOS PAC ID | 1355876749 |
|---|---|
| Medicare Enrollment ID | O20241121003314 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629787809 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kristine Pantke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033830492 PECOS PAC ID: 4284005778 Enrollment ID: I20230811000277 |
| Provider Name | Amanda Leigh Davis-scott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568977874 PECOS PAC ID: 2961853577 Enrollment ID: I20240109000224 |
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