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NPI Code Detail

MEDICARE: EMILY PRUSATOR LCSW

MEDICARE: EMILY PRUSATOR LCSW
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1336701838
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY PRUSATOR LCSW
Provider Business Mailing Address
First Line : 1737 KING ST STE 330
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-2760
Country : US
Telephone Number : 703-957-8573
Fax Number :
Provider Business Practice Location Address
First Line : 1737 KING ST STE 330
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-2760
Country : US
Telephone Number : 703-957-8573
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2019
Last Update Date : 02/10/2026

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Directions to “ EMILY PRUSATOR LCSW” Practice Location

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