Provider Demographics
NPI:1114564887
Name:DEREK MORCH LCSW LLC
Entity Type:Organization
Organization Name:DEREK MORCH LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:ANTON
Authorized Official - Last Name:MORCH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:703-755-0260
Mailing Address - Street 1:709 PENDLETON ST STE 201
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-1820
Mailing Address - Country:US
Mailing Address - Phone:703-755-0260
Mailing Address - Fax:
Practice Address - Street 1:709 PENDLETON ST STE 201
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-1820
Practice Address - Country:US
Practice Address - Phone:703-755-0260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty