| Virginia Mental Health Inc | |
|
1800 Michael Faraday Dr Ste 206 Reston VA 20190-5312 | |
| (888) 237-5426 | |
| (703) 763-2350 |
| Full Name | Virginia Mental Health Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1800 Michael Faraday Dr Ste 206, Reston, Virginia |
| Authorized Official Name and Position | Shahnoor Ali Khan (PRESIDENT) |
| Authorized Official Contact | 7034003433 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Virginia Mental Health Inc 11123 Corobon Ln Great Falls VA 22066-1403 Ph: (304) 279-9772 | Virginia Mental Health Inc 1800 Michael Faraday Dr Ste 206 Reston VA 20190-5312 Ph: (888) 237-5426 |
| NPI Number | 1356442206 |
|---|---|
| Provider Enumeration Date | 09/25/2006 |
| Last Update Date | 12/14/2023 |
| Certification Date | 12/14/2023 |
| Medicare PECOS PAC ID | 2668571522 |
|---|---|
| Medicare Enrollment ID | O20070621000712 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356442206 | NPI | - | NPPES |
| 0101235819 | Other | VA | STATE MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 0101235819 (Virginia) | Primary |
| Provider Name | Shahnoor Ali Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346342458 PECOS PAC ID: 6103719323 Enrollment ID: I20070619000359 |
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