Diane Lynn Lasichak, LCSW, LCSW-C, CMC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904004583 Issued in VA

Practice address

20459 Old Grey PL
Ashburn, VA 20147-5522

Phone

(571) 333-2889

NPI assigned

Apr 25, 2014

Last updated

Apr 25, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398384000000",
    "number": "1861812042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19309 WINMEADE DR",
            "address_2": "SUITE #334",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201766507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20459 OLD GREY PL",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475522",
            "telephone_number": "571-333-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASICHAK",
        "first_name": "DIANE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW, LCSW-C, CMC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-25",
        "last_updated": "2014-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904004583",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "10153",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith L Lamp, D.C.
• Devery Charles Landrum, LCSW
• Amaya Lane
• Kyla Lamar Lang
• Ikars V Lans, D.D.S.
• Abigail Lau
• Mackenzie Scott Lauder, PT, DPT
• Amanda Kay Lavender, DPT
• Gregory Alan Law, MD
• David Quang Le, D.D.S.

• Clinical Social Worker in Ashburn, VA
• Providers in Ashburn, 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 Apr 25, 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.