Organization · Type 2 NPI

Holystick,llc

Psychiatric/Mental Health Nurse Practitioner · Fairfax, VA

NPI number 1619506300 Active

Practice location

8550 Route 29 Ste 720
Fairfax, VA 22031-1531

Call (703) 981-5085 Map

Fax (240) 901-4515

Mailing address

14428 Homecrest Rd
Silver Spring, MD 20906-1820

Other practice locations

15200 Shady Grove Rd, Rockville, MD 20850-3218 · (240) 945-8525

Specialties and licenses

Taxonomy	Code	License
Psychiatric/Mental Health Nurse Practitioner Primary	363LP0808X	None listed
Primary Care Nurse Practitioner	363LP2300X	None listed

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

2 other providers at this address

Other psychiatric/mental health nurse practitioner providers in Fairfax

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NPI record

NPI: 1619506300
Entity type: Organization (Type 2)
Issued: Apr 3, 2020
Last updated: Jan 18, 2026
Status: Active

Other names

Acupuncture · doing business as
Medical Facility · doing business as
Holystick,llc · former legal business name

Authorized official

Hanul Jung, DOA
CEO
(240) 945-8525

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1619506300

Holystick,llc's National Provider Identifier is 1619506300, issued on Apr 3, 2020. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Fairfax, VA. The record was last updated on Jan 18, 2026.