Provider Demographics
NPI:1407582620
Name:SHIRAZI, FARAH (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:FARAH
Middle Name:
Last Name:SHIRAZI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 KNOWLES AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2428
Mailing Address - Country:US
Mailing Address - Phone:301-466-9526
Mailing Address - Fax:
Practice Address - Street 1:3930 KNOWLES AVE
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2428
Practice Address - Country:US
Practice Address - Phone:301-466-9526
Practice Address - Fax:301-949-0677
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28937106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist