Provider Demographics
NPI:1174612188
Name:RAKOFF, ROSLYN BARBARA (MSW)
Entity type:Individual
Prefix:MS
First Name:ROSLYN
Middle Name:BARBARA
Last Name:RAKOFF
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:ROZ
Other - Middle Name:
Other - Last Name:RAKOFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:254 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4517
Mailing Address - Country:US
Mailing Address - Phone:703-532-8577
Mailing Address - Fax:703-538-4507
Practice Address - Street 1:254 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4517
Practice Address - Country:US
Practice Address - Phone:703-532-8577
Practice Address - Fax:703-538-4507
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040024701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA234863OtherANTHEM
VAH2340001OtherBCBS
VA200583OtherKAISER PERMANENTE
VAH2340001OtherBCBS