Provider Demographics
NPI:1235947771
Name:TAJBAKHSH, HALEH (MS)
Entity type:Individual
Prefix:
First Name:HALEH
Middle Name:
Last Name:TAJBAKHSH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 YEONAS DR SE
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-6556
Mailing Address - Country:US
Mailing Address - Phone:571-279-4540
Mailing Address - Fax:
Practice Address - Street 1:8230 OLD COURTHOUSE RD STE 500
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3840
Practice Address - Country:US
Practice Address - Phone:703-281-4928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health