Healthcare Provider Details

I. General information

NPI: 1972147890
Provider Name (Legal Business Name): PARISA BIGDELI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2019
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21000 SOUTHBANK ST STE 106 #1246
STERLING VA
20165-7242
US

IV. Provider business mailing address

21000 SOUTHBANK ST STE 106 #1246
STERLING VA
20165-7242
US

V. Phone/Fax

Practice location:
  • Phone: 571-293-0874
  • Fax:
Mailing address:
  • Phone: 571-293-0874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904011522
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: