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

Potomac Shores Mental Health & Wellness LLC

Organization Psychiatric/Mental Health Nurse Practitioner · NPI 1902562507

Potomac Shores Mental Health & Wellness LLC is a Psychiatric/Mental Health Nurse Practitioner in Woodbridge, Virginia. Works from 3 locations. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

13000 Harbor Center Dr Ste 103
Woodbridge, VA 22192-2847
Phone: (703) 977-6556
Fax: (703) 997-1490
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1401 21st St # 7927, Sacramento, CA 95811-5226 — (888) 602-4957
  • 7777 Leesburg Pike Ste 305s, Falls Church, VA 22043-2443 — (703) 977-6556

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X

Record details

NPI number1902562507
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ebunola Ayoola — Owner · (202) 809-3550
NPI enumeratedNovember 9, 2021
Last updated in NPPESMay 2, 2025
Certification dateMay 2, 2025
Mailing address13000 Harbor Center Dr Ste 103, Woodbridge, VA 22192-2847

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