Healthcare Provider Details

I. General information

NPI: 1982616272
Provider Name (Legal Business Name): DAWN BRESSLER KAYE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3018 JAVIER RD
FAIRFAX VA
22031-4609
US

IV. Provider business mailing address

3018 JAVIER RD
FAIRFAX VA
22031-4609
US

V. Phone/Fax

Practice location:
  • Phone: 703-204-9100
  • Fax: 301-309-2596
Mailing address:
  • Phone: 703-204-9100
  • Fax: 301-309-2596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0904005659
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: