Fairfax Child and Family Therapy LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

FAIRFAX CHILD AND FAMILY THERAPY LLC

Practice address

7019 Evergreen CT # 6B
Annandale, VA 22003

Phone

(202) 810-2174

NPI assigned

Feb 5, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jee Young SukNPI 1508402066

Title

Counselor

Phone

(202) 810-2174

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jee Young Suk

  • Professional Counselor
  • Annandale, VA
  • NPI 1508402066
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1689266140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7019 EVERGREEN CT # 6B",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033227",
            "telephone_number": "202-810-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7019 EVERGREEN CT # 6B",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "22003",
            "telephone_number": "202-810-2174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFAX CHILD AND FAMILY THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-05",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "SUK",
        "authorized_official_first_name": "JEE YOUNG",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "202-810-2174"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evergreen Pharmacy, Inc (Annandale Pharmacy)
• Exeeda Wellness LLC
• Ez Health, Inc.
• Oluwole Olubunmi Fadahunsi, DMD
• Fair Ridge Orthopedics, Inc
• Fairfax Heart Associates
• Fairfax Orthopaedics, PLLC
• Fairfax Psychiatry LLC
• Fairfax Radiological Consultants PC
• Olubukola E. Falaiye, PT DPT

• Mental Health Clinic/Center (Including Community Mental Health Center) in Annandale, VA
• Providers in Annandale, VA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.