Organization
360 INNOVATIVE THERAPY LLC
Active
Other names
360 Innovative Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY MCNAIRY ED.M. (CEO)
(571) 575-3767
Entity
Organization
Contact information
Practice address
10304 EATON PL STE 100, FAIRFAX, VA 22030-2238
(571) 575-3767
(877) 525-1222
Mailing address
10304 EATON PL STE 100, FAIRFAX, VA 22030-2238
(571) 575-3767
(877) 525-1222
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
101YS0200X
School Counselor
—
—
Other
Enumeration date
03/01/2021
Last updated
03/01/2021
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