Provider Demographics
NPI:1235206343
Name:HUNT, OMAYRA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:OMAYRA
Middle Name:
Last Name:HUNT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:OMAYRA
Other - Middle Name:
Other - Last Name:AGUIRRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10712 CEDARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-2980
Mailing Address - Country:US
Mailing Address - Phone:240-222-3811
Mailing Address - Fax:
Practice Address - Street 1:720 N SAINT ASAPH ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-1912
Practice Address - Country:US
Practice Address - Phone:703-746-3505
Practice Address - Fax:703-838-5062
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040062181041C0700X
MD133341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004945026Medicaid
VA299781OtherAMERIGROUP VIRGINIA INC.
VA188791OtherANTHEM HEALTHKEEPERS
VA018910A25Medicare ID - Type Unspecified