Provider Demographics
NPI:1861244790
Name:HAKIM, JAMIE (PSYD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:HAKIM
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8030 WINSTEAD MANOR LN
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-1143
Mailing Address - Country:US
Mailing Address - Phone:703-209-2902
Mailing Address - Fax:
Practice Address - Street 1:650 PENNSYLVANIA AVE SE STE 440
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-4424
Practice Address - Country:US
Practice Address - Phone:202-544-5440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008475103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical