MEDICARE: SANDRA WERFEL MSW

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	0904000496	VA

General Provider Information

NPI Number	:	1336205426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA WERFEL MSW

Provider Business Mailing Address
First Line	:	8608 QUEEN ELIZABETH BLVD
Second Line	:
City	:	ANNANDALE
State	:	VA
Zip	:	22003-4310
Country	:	US
Telephone Number	:	703-978-2030
Fax Number	:	703-978-1881

Provider Business Practice Location Address
First Line	:	5280 LYNGATE CT
Second Line	:
City	:	BURKE
State	:	VA
Zip	:	22015-1688
Country	:	US
Telephone Number	:	703-978-2030
Fax Number	:	703-978-1881

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2006
Last Update Date	:	07/08/2007

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