Provider Demographics
NPI:1962461186
Name:HAYDASH, SYLVIA ANDERSEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:ANDERSEN
Last Name:HAYDASH
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 1:6167 RIVER FOREST DR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20112-3047
Mailing Address - Country:US
Mailing Address - Phone:703-392-7944
Mailing Address - Fax:703-878-2629
Practice Address - Street 1:7502 DIPLOMAT DR
Practice Address - Street 2:SUITE 101
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-2631
Practice Address - Country:US
Practice Address - Phone:703-392-7944
Practice Address - Fax:703-878-2629
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040043731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA11526293OtherCAQH
VA8198023Medicaid