Provider Demographics
NPI:1851964290
Name:DE ASIS, MICHAELA E (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MICHAELA
Middle Name:E
Last Name:DE ASIS
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 1:6544 SKYLEMAR TRL
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-3837
Mailing Address - Country:US
Mailing Address - Phone:703-732-3989
Mailing Address - Fax:
Practice Address - Street 1:7450 HERITAGE VILLAGE PLZ
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3090
Practice Address - Country:US
Practice Address - Phone:571-261-1921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040126211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical