Healthcare Provider Details

I. General information

NPI: 1992025209
Provider Name (Legal Business Name): SALIMA JIWA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 FAIRLAWN DR
MC LEAN VA
22101-4638
US

IV. Provider business mailing address

6601 FAIRLAWN DR
MC LEAN VA
22101-4638
US

V. Phone/Fax

Practice location:
  • Phone: 703-785-3463
  • Fax:
Mailing address:
  • Phone: 703-785-3463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904008916
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: