Provider Demographics
NPI:1114352572
Name:ROOT, CARA MICHELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:MICHELLE
Last Name:ROOT
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 1:2599 TREE HOUSE DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-1310
Mailing Address - Country:US
Mailing Address - Phone:703-599-2937
Mailing Address - Fax:
Practice Address - Street 1:7350 HERITAGE VILLAGE PLZ
Practice Address - Street 2:SUITE 201
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3084
Practice Address - Country:US
Practice Address - Phone:571-248-0626
Practice Address - Fax:866-817-3052
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
09040083521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical