Provider Demographics
NPI:1174951826
Name:SHAWKI, NANCY (LCSW)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:SHAWKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2308
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-0308
Mailing Address - Country:US
Mailing Address - Phone:703-303-3412
Mailing Address - Fax:703-991-8317
Practice Address - Street 1:4601 W OX RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6123
Practice Address - Country:US
Practice Address - Phone:410-569-9497
Practice Address - Fax:410-569-0094
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040083661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1235660499OtherGROUP NPI