Provider Demographics
NPI:1265551360
Name:PAWLOWSKI, WAYNE VINCENT (MSW, ACSW, LICSW)
Entity type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:VINCENT
Last Name:PAWLOWSKI
Suffix:
Gender:M
Credentials:MSW, ACSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 N RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-4608
Mailing Address - Country:US
Mailing Address - Phone:703-527-4948
Mailing Address - Fax:703-527-4948
Practice Address - Street 1:1724 U ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-1742
Practice Address - Country:US
Practice Address - Phone:703-887-5854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3001771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical