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General NPI Number Information
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NPI Number | 1255510111
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Entity Type | Individual
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Provider Name | TANYKA ABBOTT LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 10/29/2007
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 12531 CLIPPER DR STE 105
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City | WOODBRIDGE
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State | VA
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Zip | 22192-2355
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Country | US
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Telephone | 855-969-7877
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Fax |
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Provider Business Mailing Address
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Address Line | 12531 CLIPPER DR STE 105
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City | WOODBRIDGE
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State | VA
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Zip | 22192-2355
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Country | US
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Telephone | 804-536-7232
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0700101
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW003858
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904007532
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 13501
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW015737
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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