Healthcare Provider Details

I. General information

NPI: 1437863784
Provider Name (Legal Business Name): LAURA NATHAN-FURTUNA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURIE NATHAN MSW

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 2085
FAIRFAX VA
22031-0085
US

IV. Provider business mailing address

PO BOX 2085
FAIRFAX VA
22031-0085
US

V. Phone/Fax

Practice location:
  • Phone: 703-755-0659
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904019307
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: