Provider Demographics
NPI:1508073974
Name:ROKNI, HEIDE (MSW)
Entity Type:Individual
Prefix:MS
First Name:HEIDE
Middle Name:
Last Name:ROKNI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 WELLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-2228
Mailing Address - Country:US
Mailing Address - Phone:703-597-7943
Mailing Address - Fax:
Practice Address - Street 1:3120 WELLINGTON RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-2228
Practice Address - Country:US
Practice Address - Phone:703-597-7943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040058901041C0700X
DCLC500777841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical