Healthcare Provider Details

I. General information

NPI: 1437673167
Provider Name (Legal Business Name): MARGARET M COMISKY LCSW, C-AWSCM, MSG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2017
Last Update Date: 12/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6723 WHITTIER AVE STE 410
MC LEAN VA
22101-4533
US

IV. Provider business mailing address

6723 WHITTIER AVE
MC LEAN VA
22101-4522
US

V. Phone/Fax

Practice location:
  • Phone: --
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904009486
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: