Fatima Mirza, PHD, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904013203 Issued in VA

Practice address

10723 Main St
Fairfax, VA 22030-6905

Phone

(703) 903-9696

NPI assigned

Jun 9, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Center for Pastoral Counseling of Virginia

  • Pastoral Counselor
  • MC Lean, VA
  • NPI 1104328335
  NPD (past)
• Salma Abugideiri LPC LLC

  • Professional Counselor
  • MC Lean, VA
  • NPI 1902559149
  NPD (past)

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671926400000",
    "number": "1457700452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX QQ",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "22101",
            "telephone_number": "703-903-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10723 MAIN ST",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306905",
            "telephone_number": "703-903-9696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1716 Chain Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Mc Lean",
            "state": "VA",
            "postal_code": "221014322",
            "country_code": "US",
            "telephone_number": "703-903-9696 x209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "FATIMA",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2022-12-25",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904013203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mira Genetix
• Heather Miranda
• Kierstin Mireku
• Ahmadshah Mirkhel, M.D.
• Kenneth R Mirkin, M.D.
• Sohail K Mirza, M.D., M.P.H.
• Sulman A Mirza, M.D.
• Alina Mirzayan
• Arun P Mishra
• Leyla Missaghi, PA-C

• 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 Dec 25, 2022; 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.