FAIRFAX MENTAL HEALTH & WELLNESS
NPI 1699201749
Psychologist - Clinical in Fairfax, VA

Q: What is Fairfax Mental Health & Wellness's NPI number?

The NPI number for Fairfax Mental Health & Wellness is 1699201749. It was assigned to this organization in the NPPES registry on May 11, 2017.

Q: What is Fairfax Mental Health & Wellness's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since May 11, 2017

3554 CHAIN BRIDGE RD STE 200, FAIRFAX, VA 22030(703) 896-7628 Get Directions Write a Review

NPPES record last updated: February 19, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 19, 2025, Sep 28, 2024, May 11, 2017 (3 updates tracked since 2017).

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About Fairfax Mental Health & Wellness NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAIRFAX MENTAL HEALTH & WELLNESS (NPI 1699201749) is a healthcare organization registered as a clinical in Fairfax, Virginia and active in the NPI registry since May 2017. The organization lists Jon Shore, Ceo, as its authorized official.

NPPES Registry Identity

NPI1699201749

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameFAIRFAX MENTAL HEALTH & WELLNESS

Location Address3554 CHAIN BRIDGE RD STE 200Fairfax, VA 22030-2709

Mailing Address3554 Chain Bridge Rd Ste 200Fairfax, VA 22030-2709 · (703) 896-7628 · Fax (703) 890-2359

Phone(703) 896-7628

Organization SubpartNo

Authorized OfficialJon ShoreCeo · (732) 996-6164

Enumeration DateMay 11, 2017

Last NPPES UpdateFebruary 19, 20253 updates tracked since enumeration

NPPES CertifiedFebruary 19, 2025

✔ NPI 1699201749 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X

3554 CHAIN BRIDGE RD STE 200, Fairfax, VA 22030

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMANDA CARLSON

Social Worker (Clinical)