Healthcare Provider Details

I. General information

NPI: 1558501577
Provider Name (Legal Business Name): MERCEDES TERESA TIKOYAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2009
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8270 WILLOW OAKS CORPORATE DR
FAIRFAX VA
22031-4530
US

IV. Provider business mailing address

8270 WILLOW OAKS CORPORATE DR
FAIRFAX VA
22031-4530
US

V. Phone/Fax

Practice location:
  • Phone: 703-675-6700
  • Fax:
Mailing address:
  • Phone: 703-675-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberPPS-0601005
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904005704
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: