Healthcare Provider Details

I. General information

NPI: 1316563422
Provider Name (Legal Business Name): GABRIELLA HELENE TAWEEL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 06/24/2020
Certification Date: 06/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N QUINCY ST STE 620
ARLINGTON VA
22203-1999
US

IV. Provider business mailing address

4320 OLD DOMINION DR APT 802
ARLINGTON VA
22207-3239
US

V. Phone/Fax

Practice location:
  • Phone: 703-812-4642
  • Fax: 703-812-7926
Mailing address:
  • Phone: 703-424-3935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904011564
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: