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General NPI Number Information
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NPI Number | 1629506035
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Entity Type | Organization
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Legal Business Name | JENNIFER CANN, LCSW
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Dates
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Enumeration Date | 05/30/2017
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Last Update Date | 05/30/2017
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Provider Practice Location Address
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Address Line | 600 CAMERON ST STE 304
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2506
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Country | US
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Telephone | 703-946-2032
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Fax |
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Provider Business Mailing Address
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Address Line | 8515 CYRUS PL
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City | ALEXANDRIA
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State | VA
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Zip | 22308-2014
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Country | US
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Telephone | 703-946-2032
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER CANN
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Credential | LCSW
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Telephone | 703-946-2032
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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 | 0904006344
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License Number State | VA
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