Psychologist, Clinical
FAIRFAX MENTAL HEALTH & WELLNESS
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1699201749 · enumerated 2017-05-11 · record updated 2025-02-19. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: Mr. JON SHORE, CEO · (732) 996-6164
Addresses and phones
- Practice location 3554 CHAIN BRIDGE RD STE 200, FAIRFAX, VA, 22030-2709 (703) 896-7628 Google Maps Apple Maps OpenStreetMap
- Mailing address 3554 CHAIN BRIDGE RD STE 200, FAIRFAX, VA, 22030-2709 (703) 896-7628 Fax (703) 890-2359 Google Maps Apple Maps OpenStreetMap
Specialties
- Counselor, Professional 101YP2500X
- Psychologist, Clinical 103TC0700X · Primary
- Social Worker, Clinical 1041C0700X
- Psychiatry & Neurology, Psychiatry 2084P0800X
In this directory
Locations and evidence
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Practice location
FAIRFAX, VA, 220302709
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.