MEDICARE: RESILIENCE HUMAN SERVICES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0904007938	VA

General Provider Information

NPI Number	:	1235561846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESILIENCE HUMAN SERVICES INC.

Provider Business Mailing Address
First Line	:	9602 WATERFORD DR
Second Line	:
City	:	MANASSAS
State	:	VA
Zip	:	20110-6607
Country	:	US
Telephone Number	:	703-368-2435
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 MERCANTILE LN STE 136C
Second Line	:
City	:	LARGO
State	:	MD
Zip	:	20774-5332
Country	:	US
Telephone Number	:	240-800-1019
Fax Number	:	240-360-0369

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	NAILAH C. COOK
Credential	:	LCSW
Telephone Number	:	703-368-2534

Provider Enumeration Date	:	08/06/2013
Last Update Date	:	01/05/2026

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