Provider Demographics
NPI:1114000197
Name:SHURBERG, DORCAS A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DORCAS
Middle Name:A
Last Name:SHURBERG
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 1:9300 FOREST POINT CIRCLE
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110
Mailing Address - Country:US
Mailing Address - Phone:703-369-3222
Mailing Address - Fax:703-257-5088
Practice Address - Street 1:9300 FOREST POINT CIRCLE
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110
Practice Address - Country:US
Practice Address - Phone:703-369-3222
Practice Address - Fax:703-257-5088
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040046121041C0700X
VA0001088731163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA190001070Medicare ID - Type Unspecified