Organization
MENTAL HEALTH SERVICES EN ESPANOL LLC
Active
Other names
Victoria Transcultural Clinical Center LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IGNACIO BASAURI (ADMINISTRATIVE DIRECTOR)
(703) 218-6599
Entity
Organization
Contact information
Practice address
10565 FAIRFAX BLVD STE 300, FAIRFAX, VA 22030-3104
(703) 218-6599
(703) 890-7167
Mailing address
PO BOX 3351, FAIRFAX, VA 22038-3351
(703) 218-6599
(703) 218-2012
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
224ZE0001X
Environmental Modification Occupational Therapy Assistant
—
—
224ZF0002X
Feeding, Eating & Swallowing Occupational Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
235500000X
Speech/Language/Hearing Specialist/Technologist
—
—
2355A2700X
Audiology Assistant
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004942442
—
VA
Enumeration date
09/28/2006
Last updated
02/10/2025
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