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General NPI Number Information
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NPI Number | 1497337547
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Entity Type | Individual
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Provider Name | CARA DONNELLY-JUSTUS LCSW, LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 05/08/2024
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Provider Practice Location Address
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Address Line | 8206 LEESBURG PIKE STE 302
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City | VIENNA
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State | VA
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Zip | 22182-2614
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Country | US
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Telephone | 703-594-1535
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Fax |
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Provider Business Mailing Address
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Address Line | 12503 SANDRA LEE CT
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City | MONROVIA
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State | MD
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Zip | 21770-9032
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Country | US
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Telephone | 301-789-7634
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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 | 27224
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License Number State | MD
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