Provider Demographics
NPI:1558560631
Name:EXCEPTIONAL CHILDRENS CENTER, LLC
Entity type:Organization
Organization Name:EXCEPTIONAL CHILDRENS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-603-5863
Mailing Address - Street 1:6354 WALKER LN STE 250
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-3229
Mailing Address - Country:US
Mailing Address - Phone:037-971-0602
Mailing Address - Fax:949-863-6813
Practice Address - Street 1:6354 WALKER LN STE 250
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3229
Practice Address - Country:US
Practice Address - Phone:703-971-0602
Practice Address - Fax:949-863-6813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119002935225XP0200X
VA2202006336235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty