Provider Demographics
NPI:1538879788
Name:RESTORATIVE HEALTH ASSOCIATES, LLC
Entity type:Organization
Organization Name:RESTORATIVE HEALTH ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC MENTAL HEALTH NP
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FLICK
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C, PMHNP-BC
Authorized Official - Phone:540-207-9303
Mailing Address - Street 1:12872 HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2921
Mailing Address - Country:US
Mailing Address - Phone:540-440-5938
Mailing Address - Fax:
Practice Address - Street 1:12872 HARBOR DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2921
Practice Address - Country:US
Practice Address - Phone:540-440-5938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-29
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty