Provider Demographics
NPI:1942726302
Name:NARAGHI, GWENDOLYNN T (LICSW)
Entity Type:Individual
Prefix:MS
First Name:GWENDOLYNN
Middle Name:T
Last Name:NARAGHI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2689 LINDA MARIE DR
Mailing Address - Street 2:
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-1112
Mailing Address - Country:US
Mailing Address - Phone:202-669-2866
Mailing Address - Fax:
Practice Address - Street 1:2689 LINDA MARIE DRIVE
Practice Address - Street 2:
Practice Address - City:OAKTON
Practice Address - State:VA
Practice Address - Zip Code:22124
Practice Address - Country:US
Practice Address - Phone:202-669-2866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3032791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical