Healthcare Provider Details

I. General information

NPI: 1710735063
Provider Name (Legal Business Name): ASHLEY SKOLNITSKY MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2024
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1497 CHAIN BRIDGE RD STE 202
MC LEAN VA
22101-5728
US

IV. Provider business mailing address

1497 CHAIN BRIDGE RD STE 202
MC LEAN VA
22101-5728
US

V. Phone/Fax

Practice location:
  • Phone: 571-378-1939
  • Fax:
Mailing address:
  • Phone: 571-378-1939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0906014732
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: