| The Center for Self-development, LLC | |
|
2 Pidgeon Hill Dr Suite 450 Sterling VA 20165-6145 | |
| (703) 433-1553 | |
| (703) 433-1558 |
| Full Name | The Center for Self-development, LLC |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2 Pidgeon Hill Dr, Sterling, Virginia |
| Authorized Official Name and Position | Jill Ann Hagen, LPC (THERAPIST) |
| Authorized Official Contact | 7034331553 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Center for Self-development, LLC 2 Pidgeon Hill Dr Suite 450 Sterling VA 20165-6145 Ph: (703) 433-1553 | The Center for Self-development, LLC 2 Pidgeon Hill Dr Suite 450 Sterling VA 20165-6145 Ph: (703) 433-1553 |
| NPI Number | 1053786962 |
|---|---|
| Provider Enumeration Date | 12/03/2015 |
| Last Update Date | 12/03/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053786962 | NPI | - | NPPES |
| 4945247 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0701004125 (Virginia) | Primary |
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