Provider Demographics
NPI:1932982626
Name:LIYIM, ROLANDO (LMSW)
Entity Type:Individual
Prefix:
First Name:ROLANDO
Middle Name:
Last Name:LIYIM
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6020 ARCHSTONE WAY APT 401
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-5530
Mailing Address - Country:US
Mailing Address - Phone:201-321-4008
Mailing Address - Fax:
Practice Address - Street 1:6020 ARCHSTONE WAY APT 401
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-5530
Practice Address - Country:US
Practice Address - Phone:201-321-4008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09030036251041C0700X
VA09060129671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical