Provider Demographics
NPI:1619039153
Name:DASBACH, MONA LISA G (LICSW, LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:MONA LISA
Middle Name:G
Last Name:DASBACH
Suffix:
Gender:F
Credentials:LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WRAMC, BLDG 2, ROOM 2J38
Mailing Address - Street 2:6900 GEORGIA AVE, NW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20307-5001
Mailing Address - Country:US
Mailing Address - Phone:202-356-1012
Mailing Address - Fax:202-782-4922
Practice Address - Street 1:WRAMC, BLDG 2, DEPARTMENT OF SOCIAL WORK
Practice Address - Street 2:6900 GEORGIA AVE, NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-5001
Practice Address - Country:US
Practice Address - Phone:202-356-1012
Practice Address - Fax:202-782-4922
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3003771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical