MEDICARE: MAKAYLA A DINEEN

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		VA

General Provider Information

NPI Number	:	1699625608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAKAYLA A DINEEN

Provider Business Mailing Address
First Line	:	15909 MARLINGTON DR
Second Line	:
City	:	DUMFRIES
State	:	VA
Zip	:	22025-1343
Country	:	US
Telephone Number	:	703-407-2832
Fax Number	:

Provider Business Practice Location Address
First Line	:	4001 PRINCE WILLIAM PKWY STE 301
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22192-7667
Country	:	US
Telephone Number	:	703-688-8541
Fax Number	:

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

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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Directions to “ MAKAYLA A DINEEN ” Practice Location

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