Provider Demographics
NPI:1851162010
Name:BLUE RIDGE MENTAL HEALTH
Entity type:Organization
Organization Name:BLUE RIDGE MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:BIXBY
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:571-334-9759
Mailing Address - Street 1:1198 HAWLING PL SW
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-5084
Mailing Address - Country:US
Mailing Address - Phone:571-334-9759
Mailing Address - Fax:
Practice Address - Street 1:722 E MARKET ST # V79
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3255
Practice Address - Country:US
Practice Address - Phone:571-569-0560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health