Healthcare Provider Details

I. General information

NPI: 1427622356
Provider Name (Legal Business Name): HALEH ROYANIAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2021
Last Update Date: 07/08/2023
Certification Date: 07/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8709 KERRY LN
SPRINGFIELD VA
22152-3206
US

IV. Provider business mailing address

8709 KERRY LN
SPRINGFIELD VA
22152-3206
US

V. Phone/Fax

Practice location:
  • Phone: 571-216-9848
  • Fax:
Mailing address:
  • Phone: 571-216-9848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0904002684
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: