Organization
FAIRFAX COUNTY, VIRGINIA
Active
Other names
Fairfax-Falls Church Community Services Board
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA WADLEY-YOUNG (ACTING EXECUTIVE DIRECTOR)
(703) 324-4431
Entity
Organization
Contact information
Practice address
12011 GOVERNMENT CENTER PARKWAY, SUITE 836, FAIRFAX, VA 22035
(703) 324-7000
(703) 653-6626
Mailing address
12011 GOVERNMENT CENTER PKWY STE 836, FAIRFAX, VA 22035-1100
(703) 324-7000
(703) 653-6626
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
113
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945107
—
VA
05
—
008743126
—
VA
05
—
010200181
—
VA
05
—
010200229
—
VA
05
—
010200270
—
VA
01
—
222044
ANTHEM
VA
01
—
541705851
TRICARE
—
01
—
5700
CAREFIRST BCBS NCA
—
01
—
MHSS
AMERIGROUP
VA
Enumeration date
07/11/2006
Last updated
03/17/2026
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