| Lifeworks Outreach Services, Inc. | |
|
4300 Ridgewood Center Dr Unit A Woodbridge VA 22192-5307 | |
| (703) 580-7210 | |
| (703) 580-7213 |
| Full Name | Lifeworks Outreach Services, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4300 Ridgewood Center Dr Unit A, Woodbridge, Virginia |
| Authorized Official Name and Position | Maureen Victoria Fannin (CLINICAL DIRECTOR/OWNER) |
| Authorized Official Contact | 7035807210 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeworks Outreach Services, Inc. 4300 Ridgewood Center Dr Unit A Woodbridge VA 22192-5307 Ph: (703) 580-7210 | Lifeworks Outreach Services, Inc. 4300 Ridgewood Center Dr Unit A Woodbridge VA 22192-5307 Ph: (703) 580-7210 |
| NPI Number | 1962789495 |
|---|---|
| Provider Enumeration Date | 11/11/2011 |
| Last Update Date | 11/11/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962789495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 1039-05-001 (Virginia) | Primary |
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