Provider Demographics
NPI:1760573760
Name:VEMURI, GAYATHRI (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:GAYATHRI
Middle Name:
Last Name:VEMURI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:GAYATRI
Other - Middle Name:
Other - Last Name:SAGGURTHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:18725 NATHANS PL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-4242
Mailing Address - Country:US
Mailing Address - Phone:301-330-9627
Mailing Address - Fax:
Practice Address - Street 1:6900 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-0003
Practice Address - Country:US
Practice Address - Phone:202-782-8060
Practice Address - Fax:202-782-8379
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040061621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical