Babak Alidoosti, LMFT

Individual provider Active NPI Marriage & Family Therapist · Gainesville, VA

NPI 1629500293 · NPPES record last updated Apr 1, 2017

Key facts

NPI
1629500293
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
0717001365 (VA)
Practice address
7230 Heritage Village PLZ
Suite 202
Gainesville, VA 20155-3053
Phone
(703) 754-0636
NPI assigned
Apr 1, 2017
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0717001365VAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Marriage Healing Center, LLC Past Accepting new patients
Life Enrichment Counseling Center, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0717001365 VA Yes

Addresses

Primary practice location

7230 Heritage Village PLZ
Suite 202
Gainesville, VA 20155-3053

Mailing address

4614 Hull Dr
Haymarket, VA 20169-8182
Phone (301) 788-6277

Other providers in Gainesville, VA

All providers in Gainesville, VA · Marriage & Family Therapist in Virginia

Sources for this page

Verify at the official NPI Registry.