Healthcare Provider Details

I. General information

NPI: 1366768467
Provider Name (Legal Business Name): DEBRA L TIEVSKY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2010
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 3978
OAKTON VA
22124-3978
US

IV. Provider business mailing address

PO BOX 3978
OAKTON VA
22124-3978
US

V. Phone/Fax

Practice location:
  • Phone: 703-715-6011
  • Fax:
Mailing address:
  • Phone: 703-338-9708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904001786
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: