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360 INNOVATIVE THERAPY LLC
NPI 1770178816
Counselor - Addiction (Substance Use Disorder) in Fairfax, VA

Active since March 01, 2021
10304 EATON PL STE 100, FAIRFAX, VA 22030(571) 575-3767(877) 525-1222 Get Directions Write a Review

NPPES record last updated: March 1, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About 360 Innovative Therapy Llc NPPES

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

360 INNOVATIVE THERAPY LLC (NPI 1770178816), doing business as 360 Innovative Therapy, is a healthcare organization registered as an addiction (substance use disorder) in Fairfax, Virginia and active in the NPI registry since March 2021. The organization lists Beverly Mcnairy, Ceo, as its authorized official.

NPPES Registry Identity

NPI1770178816
Entity TypeOrganization
Primary Taxonomy101YA0400X
Legal Business Name360 INNOVATIVE THERAPY LLC
Location Address10304 EATON PL STE 100Fairfax, VA 22030-2238
Mailing Address10304 Eaton Pl Ste 100Fairfax, VA 22030-2238 · (571) 575-3767 · Fax (877) 525-1222
Phone(571) 575-3767
Fax(877) 525-1222
Organization SubpartNo
Authorized OfficialBeverly McnairyCeo · (571) 575-3767
Enumeration DateMarch 1, 2021
NPPES CertifiedFebruary 26, 2021
✔ NPI 1770178816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
Also ListedCounselorTaxonomy 101Y00000X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedCounselor · SchoolTaxonomy 101YS0200X
10304 EATON PL STE 100, Fairfax, VA 22030
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Other Names 1

Doing Business As360 Innovative Therapy

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

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

CALVIN LAYNE III PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
10304 EATON PL STE 100
FAIRFAX, VA 22030
Fairfax City (571) 463-8620
VALERIE KAY KEEHN BCBA
Behavior Analyst
10304 EATON PL STE 100
FAIRFAX, VA 22030
Fairfax City (855) 295-3276
KODA BRINKER PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
10304 EATON PL STE 100
FAIRFAX, VA 22030
Fairfax City (571) 463-8620
LIFESPEED MEDICAL, LLC
Durable Medical Equipment & Medical Supplies
10304 EATON PL STE 100
FAIRFAX, VA 22030
Fairfax City (352) 232-3540
LIBAN ABDALLA
Behavior Technician
10304 EATON PL STE 100
FAIRFAX, VA 22030
Fairfax City (813) 761-0264
ANIKA LAMBA
Behavior Technician
10304 EATON PL STE 100
FAIRFAX, VA 22030
Fairfax City (813) 461-0264
FOR THE GOOD THERAPEUTIC SERVICES INC.
Counselor (Professional)
10304 EATON PL STE 100
FAIRFAX, VA 22030
Fairfax City (571) 412-1791
ANGIE IRAHETA GRUESSING
Behavior Technician
10304 EATON PL STE 100
FAIRFAX, VA 22030
Fairfax City (813) 761-0264

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 360 Innovative Therapy LLC's NPI number?

The NPI number for 360 Innovative Therapy LLC is 1770178816. It was assigned to this organization in the NPPES registry on March 1, 2021. The provider is doing business as 360 Innovative Therapy.

Where is 360 Innovative Therapy LLC located?

360 Innovative Therapy LLC is located at 10304 Eaton Pl Ste 100, Fairfax, VA 22030. The listed phone number is (571) 575-3767.

What is 360 Innovative Therapy LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for 360 Innovative Therapy LLC was last updated on March 1, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.