Adolescent and Family Growth Center, Inc.
Organization Active NPI Clinical Social Worker · Springfield, VA
NPI 1295875375 · NPPES record last updated Aug 2, 2012
Key facts
- NPI
- 1295875375
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- ADOLESCENT AND FAMILY GROWTH CENTER, INC.
- Practice address
- 8000 Forbes PL
Suite 201
Springfield, VA 22151-2200 - Phone
- (703) 425-9200
- Fax
- (703) 425-9206
- NPI assigned
- Feb 7, 2007
- Organization subpart
- No
Authorized official
- Name
- Jermaine H. Johnson, MS, MFT
- Title
- Executive Director
- Phone
- (703) 425-9200
Practitioners 2
-
Wendy Umbarger, LCSW
-
Marianne Longshore Werth, LCSW
National Provider Directory
Locations
8000 Forbes Pl
Ste 201
Springfield, VA 22151
Phone (703) 425-9200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | Yes | ||
| Marriage & Family Therapist |
106H00000X | |||
| Psychiatry Physician |
2084P0800X | |||
| Community/Behavioral Health Agency | 251S00000X | 24203001 | VA |
Addresses
Primary practice location
8000 Forbes PL
Suite 201
Springfield, VA 22151-2200
Mailing address
8000 Forbes PL
Suite 201
Springfield, VA 22151-2200
Phone (703) 425-9200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000200191 | Medicaid | VA |
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All providers in Springfield, VA · Clinical Social Worker in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.