Provider Demographics
NPI:1679648802
Name:BIRD, SALLY F (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:F
Last Name:BIRD
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 S GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204
Mailing Address - Country:US
Mailing Address - Phone:703-271-8529
Mailing Address - Fax:703-271-0434
Practice Address - Street 1:404 S GARFIELD ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204
Practice Address - Country:US
Practice Address - Phone:703-271-8529
Practice Address - Fax:703-271-0434
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040020751041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
H2510001OtherBCBS
117549OtherVALUE OPTIONS
195414OtherCOM PSYCH
096635OtherMHN
088962OtherANTHEM
5282547OtherAETNA
11160048OtherHMS