Provider Demographics
NPI:1043536121
Name:MENTAL HEALTH RECOVERY PLLC
Entity type:Organization
Organization Name:MENTAL HEALTH RECOVERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:N
Authorized Official - Last Name:COWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:703-887-2475
Mailing Address - Street 1:436 N ARMISTEAD ST APT 101
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-3425
Mailing Address - Country:US
Mailing Address - Phone:703-354-5104
Mailing Address - Fax:
Practice Address - Street 1:7330 B MCWHORTER PLACE
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003
Practice Address - Country:US
Practice Address - Phone:703-887-2475
Practice Address - Fax:703-642-6082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040073121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty