Healthcare Provider Details

I. General information

NPI: 1861327769
Provider Name (Legal Business Name): MADIHA BAIG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6849 OLD DOMINION DR STE 315
MC LEAN VA
22101-3733
US

IV. Provider business mailing address

9618 TACKROOM LN
GREAT FALLS VA
22066-2000
US

V. Phone/Fax

Practice location:
  • Phone: 571-378-1398
  • Fax:
Mailing address:
  • Phone: 484-636-8244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904020454
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: