Provider Demographics
NPI:1407932783
Name:HUSSEN, UBAX A (LCSW, MPH)
Entity Type:Individual
Prefix:MS
First Name:UBAX
Middle Name:A
Last Name:HUSSEN
Suffix:
Gender:F
Credentials:LCSW, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 SEMINARY RD
Mailing Address - Street 2:UNIT #1314S
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-3901
Mailing Address - Country:US
Mailing Address - Phone:703-341-7831
Mailing Address - Fax:
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2916
Practice Address - Country:US
Practice Address - Phone:202-476-2479
Practice Address - Fax:202-476-4162
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040060771041C0700X
DCLC500784971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCLC50078497OtherDISTRICT OF COLUMBIA
VA#0904006077 (LCSW)OtherCOMMONWEALTH OF VA