Provider Demographics
NPI:1477629350
Name:ALSAFFAR, LAURI (LCSWC)
Entity Type:Individual
Prefix:
First Name:LAURI
Middle Name:
Last Name:ALSAFFAR
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:LAURI
Other - Last Name:MORROW ALSAFFAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWC
Mailing Address - Street 1:2275 RESEARCH BLVD
Mailing Address - Street 2:# 500
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850
Mailing Address - Country:US
Mailing Address - Phone:301-320-6926
Mailing Address - Fax:301-263-0561
Practice Address - Street 1:2275 RESEARCH BLVD
Practice Address - Street 2:# 500
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850
Practice Address - Country:US
Practice Address - Phone:301-320-6926
Practice Address - Fax:301-263-0561
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD051661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
791080Medicare ID - Type Unspecified