Provider Demographics
NPI:1477887701
Name:BATENGA, CARLA SUAREZ (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:CARLA
Middle Name:SUAREZ
Last Name:BATENGA
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 1:25467 VACATION PL
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-3417
Mailing Address - Country:US
Mailing Address - Phone:703-405-3228
Mailing Address - Fax:703-327-8098
Practice Address - Street 1:25467 VACATION PL
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-3417
Practice Address - Country:US
Practice Address - Phone:703-405-3228
Practice Address - Fax:703-327-8098
Is Sole Proprietor?:No
Enumeration Date:2009-09-18
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
VA09040076821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health