Healthcare Provider Details

I. General information

NPI: 1922999754
Provider Name (Legal Business Name): DENISE RIBAS CAVALCANTE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10721 MAIN ST STE 2400
FAIRFAX VA
22030-6902
US

IV. Provider business mailing address

10721 MAIN ST STE 2400
FAIRFAX VA
22030-6902
US

V. Phone/Fax

Practice location:
  • Phone: 703-270-0225
  • Fax: 703-459-9620
Mailing address:
  • Phone: 703-270-0225
  • Fax: 703-459-9620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904020882
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: