Organization
NOVA PSYCHIATRIST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MADAN KUMAR UPRETY M.D. (MEMBER)
(703) 596-4796
Entity
Organization
Contact information
Practice address
12359 SUNRISE VALLEY DR, SUITE 320, RESTON, VA 20191-3462
(703) 596-4796
(703) 435-6747
Mailing address
12359 SUNRISE VALLEY DR, SUITE 320, RESTON, VA 20191-3462
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103G00000X
Clinical Neuropsychologist
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Enumeration date
10/24/2014
Last updated
10/24/2014
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