Provider Demographics
NPI:1245331107
Name:MAY, JIVAN S (LCSWC)
Entity type:Individual
Prefix:MS
First Name:JIVAN
Middle Name:S
Last Name:MAY
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 PRINCESS ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2211
Mailing Address - Country:US
Mailing Address - Phone:202-257-8824
Mailing Address - Fax:703-683-3779
Practice Address - Street 1:2331 MILL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4677
Practice Address - Country:US
Practice Address - Phone:202-257-8824
Practice Address - Fax:703-683-3779
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040060031041C0700X
MD130021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical