Georgina Antakly, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

50079964 Issued in DC

Practice address

1201 N Fillmore St
Apt 1011
Arlington, VA 22201-2876

Phone

(240) 481-1039

NPI assigned

Jan 10, 2011

Last updated

Jul 15, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405382400000",
    "number": "1306140058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 N FILLMORE ST",
            "address_2": "APT 1011",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222012876",
            "telephone_number": "240-481-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N FILLMORE ST",
            "address_2": "APT 1011",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222012876",
            "telephone_number": "240-481-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTAKLY",
        "first_name": "GEORGINA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-10",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079737",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "50079964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Arlington, VA
• Providers in Arlington, 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 Jul 15, 2014; 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.