Healthcare Provider Details

I. General information

NPI: 1396924569
Provider Name (Legal Business Name): HARRY LINCOLN AYLING LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2007
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 MARK CENTER DR
ALEXANDRIA VA
22311-1882
US

IV. Provider business mailing address

4850 MARK CENTER DR
ALEXANDRIA VA
22311-1882
US

V. Phone/Fax

Practice location:
  • Phone: 703-746-3400
  • Fax:
Mailing address:
  • Phone: 703-746-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904003857
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: