Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fairfax Mental Health & Wellness

Organization Professional Counselor · NPI 1699201749

Fairfax Mental Health & Wellness is a Professional Counselor in Fairfax, Virginia. Registered with an NPI since 2017.

In the registry since
2017
Specialties on file
4

Practice location Address checks out

3554 Chain Bridge Rd Ste 200
Fairfax, VA 22030-2709
Phone: (703) 896-7628
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X
Professional Counselor Taxonomy 101YP2500X
Clinical Social Worker Taxonomy 1041C0700X
Psychiatry Physician Taxonomy 2084P0800X

Record details

NPI number1699201749
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jon Shore — Ceo · (732) 996-6164
NPI enumeratedMay 11, 2017
Last updated in NPPESFebruary 19, 2025
Certification dateFebruary 19, 2025
Mailing address3554 Chain Bridge Rd Ste 200, Fairfax, VA 22030-2709

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