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Organization
ADOLESCENT AND FAMILY GROWTH CENTER, INC.
Active
Organization
ADOLESCENT AND FAMILY GROWTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERMAINE H. JOHNSON MS, MFT (EXECUTIVE DIRECTOR)
(703) 425-9200
Entity
Organization
Contact information
Practice address
8000 FORBES PL, SUITE 201, SPRINGFIELD, VA 22151-2200
(703) 425-9200
(703) 425-9206
Mailing address
8000 FORBES PL, SUITE 201, SPRINGFIELD, VA 22151-2200
(703) 425-9200
(703) 425-9206
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
24203001
VA
Other
Enumeration date
02/07/2007
Last updated
08/02/2012
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