Provider Demographics
NPI:1447402938
Name:LEVY, FERN L (LCSW)
Entity Type:Individual
Prefix:
First Name:FERN
Middle Name:L
Last Name:LEVY
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 1:210 E BROAD ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4505
Mailing Address - Country:US
Mailing Address - Phone:703-850-3033
Mailing Address - Fax:703-273-4043
Practice Address - Street 1:210 E BROAD ST
Practice Address - Street 2:SUITE 208
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4505
Practice Address - Country:US
Practice Address - Phone:703-850-3033
Practice Address - Fax:703-273-4043
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040049681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical