Healthcare Provider Details

I. General information

NPI: 1184820011
Provider Name (Legal Business Name): DENISE GAY GREENWOOD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 N SAINT ASAPH ST
ALEXANDRIA VA
22314-1912
US

IV. Provider business mailing address

5585 CALLCOTT WAY UNIT 1082
ALEXANDRIA VA
22312
US

V. Phone/Fax

Practice location:
  • Phone: 703-838-4455
  • Fax:
Mailing address:
  • Phone: 727-577-7642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904006551
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW8127
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: