Provider Demographics
NPI:1750500500
Name:UROW, JACQUELINE D (LCSW)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:D
Last Name:UROW
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 1:7011 HOLYROOD DR
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-1553
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1364 BEVERLY RD
Practice Address - Street 2:SUITE 304
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3600
Practice Address - Country:US
Practice Address - Phone:703-761-7520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904002420104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker