Healthcare Provider Details

I. General information

NPI: 1346051695
Provider Name (Legal Business Name): RAMON PALAZZOLO LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8119 HOLLAND RD
ALEXANDRIA VA
22306-3135
US

IV. Provider business mailing address

8119 HOLLAND RD
ALEXANDRIA VA
22306-3135
US

V. Phone/Fax

Practice location:
  • Phone: 703-559-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904017865
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: