Provider Demographics
NPI:1881113934
Name:VICENTE, MAGALY CRISTINA (LCSW)
Entity type:Individual
Prefix:MS
First Name:MAGALY
Middle Name:CRISTINA
Last Name:VICENTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MAGALY
Other - Middle Name:
Other - Last Name:LLANOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1320 N VEITCH ST UNIT 1105
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-6207
Mailing Address - Country:US
Mailing Address - Phone:301-788-1320
Mailing Address - Fax:
Practice Address - Street 1:2100 WASHINGTON BLVD FL 4
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-5717
Practice Address - Country:US
Practice Address - Phone:703-228-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-10
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD184601041C0700X
VA09040113741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical