Organization · Type 2 NPI

360 Innovative Therapy LLC

Addiction (Substance Use Disorder) Counselor · Fairfax, VA

NPI number 1770178816 Active

Practice location

10304 Eaton Pl Ste 100
Fairfax, VA 22030-2238

Call (571) 575-3767 Map

Fax (877) 525-1222

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000XNone listed
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed
Mental Health Counselor 101YM0800XNone listed
School Counselor 101YS0200XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1770178816

360 Innovative Therapy LLC's National Provider Identifier is 1770178816, issued on Mar 1, 2021. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Fairfax, VA. The record was last updated on Mar 1, 2021.