# ADOLESCENT AND FAMILY GROWTH CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295875375
- **Authorized official:** JERMAINE H. JOHNSON MS, MFT (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (703) 425-9200

## Contact information

- **Practice address:** 8000 FORBES PL, SUITE 201, SPRINGFIELD, VA 22151-2200
- **Practice address phone:** (703) 425-9200
- **Practice address fax:** (703) 425-9206
- **Mailing address:** 8000 FORBES PL, SUITE 201, SPRINGFIELD, VA 22151-2200
- **Mailing address phone:** (703) 425-9200
- **Mailing address fax:** (703) 425-9206

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |
| 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