Organization · Type 2 NPI

Live Well Healthcare

Psychiatric/Mental Health Nurse Practitioner · Ashburn, VA

NPI number 1912612904 Active

Practice location

20130 Lakeview Center Plz Ste 400
Ashburn, VA 20147-5905

Fax (571) 365-7530

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808XNone listed

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

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About NPI 1912612904

Live Well Healthcare's National Provider Identifier is 1912612904, issued on Jan 16, 2023. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Ashburn, VA. The record was last updated on Oct 7, 2026.