Organization
BEHAVIORAL CONSULTING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER SMITH (PROGRAM DIRECTOR)
(703) 232-9691
Entity
Organization
Contact information
Practice address
12656 LAKE RIDGE DR STE C, WOODBRIDGE, VA 22192-7504
(703) 910-4362
Mailing address
12656 LAKE RIDGE DR STE C, WOODBRIDGE, VA 22192-7504
(703) 910-4362
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0134000133
VA
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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