Healthcare Provider Details

I. General information

NPI: 1821746686
Provider Name (Legal Business Name): KHANDI GARRAWAY MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2022
Last Update Date: 03/11/2022
Certification Date: 03/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 N CENTER DR STE 200
NORFOLK VA
23502-4008
US

IV. Provider business mailing address

6330 N CENTER DR STE 200
NORFOLK VA
23502-4008
US

V. Phone/Fax

Practice location:
  • Phone: 757-233-0003
  • Fax:
Mailing address:
  • Phone: 757-233-0003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: