Provider Demographics
NPI:1336370790
Name:KAJECKAS, GABRIEL GEDIMINAS (LCSW-C)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:GEDIMINAS
Last Name:KAJECKAS
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11604 HUNTERS GREEN CT
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-3506
Mailing Address - Country:US
Mailing Address - Phone:703-216-8390
Mailing Address - Fax:703-716-8555
Practice Address - Street 1:4848 BATTERY LN STE 202
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2703
Practice Address - Country:US
Practice Address - Phone:703-216-8390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09040034771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical