Provider Demographics
NPI:1538453683
Name:ALEXANDRA KAGHAN, LCSW, LLC
Entity type:Organization
Organization Name:ALEXANDRA KAGHAN, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KAGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:703-319-1436
Mailing Address - Street 1:243 CHURCH ST NW
Mailing Address - Street 2:SUITE 300A
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4434
Mailing Address - Country:US
Mailing Address - Phone:703-319-1436
Mailing Address - Fax:703-938-8393
Practice Address - Street 1:243 CHURCH ST NW
Practice Address - Street 2:SUITE 300A
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4434
Practice Address - Country:US
Practice Address - Phone:703-319-1436
Practice Address - Fax:703-938-8393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty