Provider Demographics
NPI:1346937794
Name:DAVILA, MARIELA D (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIELA
Middle Name:D
Last Name:DAVILA
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 1:8350 RICHMOND HWY STE 515
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-2345
Mailing Address - Country:US
Mailing Address - Phone:703-533-5424
Mailing Address - Fax:703-653-6613
Practice Address - Street 1:8350 RICHMOND HWY STE 515
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22309-2345
Practice Address - Country:US
Practice Address - Phone:703-533-5424
Practice Address - Fax:703-653-6613
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040151061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical