Provider Demographics
NPI:1942691993
Name:ORTIZ, ANA GRACIELA (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:GRACIELA
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N GLEBE RD
Mailing Address - Street 2:SUITE 506
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-3728
Mailing Address - Country:US
Mailing Address - Phone:703-751-4083
Mailing Address - Fax:
Practice Address - Street 1:200 N GLEBE RD
Practice Address - Street 2:SUITE 506
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-3728
Practice Address - Country:US
Practice Address - Phone:703-751-4083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040054451041C0700X
MD119111041C0700X
DCLC500777091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical