Provider Demographics
NPI:1154078046
Name:SILVIS, BLAIR DUNAWAY (LICSW)
Entity Type:Individual
Prefix:
First Name:BLAIR
Middle Name:DUNAWAY
Last Name:SILVIS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:BLAIR
Other - Last Name:DUNAWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2910 S DINWIDDIE ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-1406
Mailing Address - Country:US
Mailing Address - Phone:678-572-2869
Mailing Address - Fax:
Practice Address - Street 1:2910 S DINWIDDIE ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-1406
Practice Address - Country:US
Practice Address - Phone:678-572-2869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040166801041C0700X
DCLC2000030321041C0700X
DCLG2000001512104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical