Provider Demographics
NPI:1629955695
Name:GALAXY BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:GALAXY BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANANSA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:571-358-8771
Mailing Address - Street 1:10432 BALLS FORD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-2517
Mailing Address - Country:US
Mailing Address - Phone:571-279-8264
Mailing Address - Fax:571-376-6540
Practice Address - Street 1:8990 ACADEMIC LOOP APT 204
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-4013
Practice Address - Country:US
Practice Address - Phone:571-279-8264
Practice Address - Fax:571-376-6540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-20
Last Update Date:2025-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty