Provider Demographics
NPI:1225606882
Name:RABAGO, CALVIN JEFFREY (LCSW)
Entity Type:Individual
Prefix:
First Name:CALVIN
Middle Name:JEFFREY
Last Name:RABAGO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 WILSON BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-3324
Mailing Address - Country:US
Mailing Address - Phone:267-992-0812
Mailing Address - Fax:
Practice Address - Street 1:2200 WILSON BLVD STE 102
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-3324
Practice Address - Country:US
Practice Address - Phone:267-992-0812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500825791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical