Individual provider Active NPI

Hiawkal Gizachew, LCSW

  • Clinical Social Worker
  • Alexandria, VA
National Provider Identifier
1174905756
Registry record updated Jun 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904009036 Issued in VA
Practice address
4529 Southland Ave
Alexandria, VA 22312-1621
Phone
(703) 531-9325
Fax
(703) 619-0045
NPI assigned
Jun 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904009036 VA Primary

Addresses

Primary practice location

4529 Southland Ave
Alexandria, VA 22312-1621

Mailing address

4529 Southland Ave
Alexandria, VA 22312-1621
Phone (703) 531-9325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0904009036VAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434672000000",
    "number": "1174905756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4529 SOUTHLAND AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223121621",
            "telephone_number": "703-531-9325",
            "fax_number": "703-619-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4529 SOUTHLAND AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223121621",
            "telephone_number": "703-531-9325",
            "fax_number": "703-619-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIZACHEW",
        "first_name": "HIAWKAL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2015-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.