Healthcare Provider Details

I. General information

NPI: 1932509874
Provider Name (Legal Business Name): PALESA A. OSEI-TUTU LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2014
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18223 SUMMIT POINTE DR
TRIANGLE VA
22172-1136
US

IV. Provider business mailing address

14497 POTOMAC MILLS RD # 1159
WOODBRIDGE VA
22192-6807
US

V. Phone/Fax

Practice location:
  • Phone: 571-406-3144
  • Fax: 703-783-6752
Mailing address:
  • Phone: 571-406-3144
  • Fax: 703-783-6752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904008689
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: