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

Holistic Functional Wellness Center, PLLC

Organization Clinical Social Worker · NPI 1649032970

Holistic Functional Wellness Center, PLLC is a Clinical Social Worker in Woodbridge, Virginia. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12910 Harbor Dr
Woodbridge, VA 22192-2930
Phone: (347) 835-2989
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1649032970
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Erwin Reyna — President · (347) 835-2989
NPI enumeratedJanuary 23, 2024
Last updated in NPPESJanuary 31, 2025
Certification dateJanuary 31, 2025
Mailing address12910 Harbor Dr, Woodbridge, VA 22192-2930

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