Vanguard Therapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904008366 Issued in VA

Legal business name

VANGUARD THERAPY, LLC

Practice address

9663 Main St Ste D
Fairfax, VA 22031-3758

Phone

(703) 303-8832

NPI assigned

Mar 21, 2017

Organization subpart

Yes

Parent organization

VANGUARD THERAPY, LLCAs reported in NPPES

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

Authorized official

Name

Nancy Shawki, LCSW

Title

Lead Therapist

Phone

(703) 303-3412

Specialties & licenses 1

Addresses

Part of

Vanguard Therapy LLC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carly Ikuma

  • Professional Counselor
  • Fairfax, VA
  • NPI 1427571629
  NPD (past)

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490054400000",
    "number": "1235660499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9663 MAIN ST STE D",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313758",
            "telephone_number": "703-303-8832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9663 MAIN ST STE D",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313758",
            "telephone_number": "703-303-8832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANGUARD THERAPY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VANGUARD THERAPY, LLC",
        "enumeration_date": "2017-03-21",
        "last_updated": "2017-03-21",
        "status": "A",
        "authorized_official_last_name": "SHAWKI",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "LEAD THERAPIST",
        "authorized_official_telephone_number": "703-303-3412",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lia H. Van, NP
• Elizabeth Rose Vance, MS CCC-SLP
• Dena Vandagriff, ATC
• Abby Louise Vandegrift, OTR/L
• Sooyoung Vandemark, MD
• Lisa G Vanlahr
• Maribel Masangkay Vann, D.D.S.
• Michael J. Varanelli, MD
• Viviana Varela Rosa, OD
• Stephen Earl Varga, M.D.

• Clinical Social Worker in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; 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.