# PARADOX MENTAL HEALTH

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

## Provider details

- **NPI number:** 1316712854
- **Authorized official:** STEPHANIE DAVILA PMHNP-BC (OWNER)
- **Authorized official phone:** (703) 932-9964

## Contact information

- **Practice address:** 12872 HARBOR DR, WOODBRIDGE, VA 22192-2921
- **Practice address phone:** (571) 946-5512
- **Practice address fax:** (571) 376-6506
- **Mailing address:** 6857 JOCKEY CLUB LN, HAYMARKET, VA 20169-2979
- **Mailing address phone:** (703) 932-9964

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 11/15/2023
- **Last updated:** 07/09/2024