| Mindsparks. LLC | |
|
1765 Greensboro Station Pl Ste 900 Mc Lean VA 22102-3470 | |
| (703) 481-9800 | |
| (703) 481-9801 |
| Full Name | Mindsparks. LLC |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1765 Greensboro Station Pl Ste 900, Mc Lean, Virginia |
| Authorized Official Name and Position | Omaira Qazi (PRESIDENT) |
| Authorized Official Contact | 7035072692 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindsparks. LLC 1765 Greensboro Station Pl Ste 900 Mc Lean VA 22102-3470 Ph: (703) 481-9800 | Mindsparks. LLC 1765 Greensboro Station Pl Ste 900 Mc Lean VA 22102-3470 Ph: (703) 481-9800 |
| NPI Number | 1942019211 |
|---|---|
| Provider Enumeration Date | 01/02/2025 |
| Last Update Date | 01/02/2025 |
| Certification Date | 12/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942019211 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (NU) | Primary |
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