KELLY FACCIOLA


Address: 12866 Harbor Dr, Woodbridge, VA 22192-2921
Phone: 7034944164

KELLY FACCIOLA (NPI# 1598873101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1598873101
Entity Type Individual
Full Name KELLY FACCIOLA
Credential LCSW
Practice Address 12866 Harbor Dr
Woodbridge
VA 22192-2921
Practice Telephone 7034944164
Practice Fax Number 7035639304
Mailing Telephone 7032037535
Mailing Fax Number 7035639304
Enumeration Date 2006-08-25
Last Update Date 2019-08-07
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1041C0700X Social Worker
Specialization: Clinical
0904005064 VA Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
VA 010023700 05

Office Location

Street Address 12866 HARBOR DR
City WOODBRIDGE
State VA
Zip Code 22192-2921

Providers in the same location

NPI Name Taxonomy Address Enumeration
1275032740 Meghan Patricia Baglio Social Worker 12866 Harbor Dr, Woodbridge, VA 22192-2921 2018-02-09
1780834911 Occoquan Counseling, LLC Social Worker 12866 Harbor Dr, Woodbridge, VA 22192-2921 2008-09-24
1790903755 Mary Elizabeth (bets) Byrne Social Worker 12866 Harbor Dr, Woodbridge, VA 22192-2921 2007-04-23
1063565430 Brian Chandler Hand Psychologist 12866 Harbor Dr, Woodbridge, VA 22192-2921 2007-01-19

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1245873645 Ursula Jackson Technician 3500 Commission Ct, Woodbridge, VA 22192 2019-10-18
1205480779 Ki Soo Park Physical Therapy Assistant 12825 Minnieville Road Suite 201, Lake Ridge, VA 22192 2019-08-01
1801448329 Karen Lee Trivett Specialist/Technologist, Other 12584 Darby Brook Court, Woodbridge, VA 22192 2019-07-15
1407313166 Nichele Amelia Thompson Behavioral Analyst 2731 Marblestone Dr, 101, Woodbridge, VA 22192 2019-02-28
1952877870 Kimberly Ann Rojas Vazquez Behavioral Analyst 12531 Clipper Dr, Suite 203, Woodbridge, VA 22192 2018-10-18
1104391614 Ykim Dental Dentist 2680 Optiz Blvd., Suite 120, Woodbridge, VA 22192 2018-10-11
1013418755 Arm Transport Non-emergency Medical Transport (VAN) 13000 Harbor Center Dr Ste 132d, Woodbridge, VA 22192 2018-02-27
1811496813 Francesca Nasi Behavioral Analyst 12531 Clipper Dr Ste 203, Woodbridge, VA 22192 2018-02-05
1942729504 Bismark Transportation Service LLC Non-emergency Medical Transport (VAN) 12341 Woodlawn Court, Woodbridge, VA 22192 2017-09-14
1992226344 Arm Baby Eldery Home Health LLC Home Health 13000 Harbor Center Dr # 312c, Woodbridge, VA 22192 2017-07-06
Find all providers in zip 22192

Taxonomy Information

Taxonomy Code 1041C0700X
Grouping Behavioral Health & Social Service Providers
Classification Social Worker
Specialization Clinical

Taxonomy Definition

A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1518568518 Ruth Ilboudo Social Worker 15732 John Diskin Cir, Woodbridge, VA 22191-6550 2020-11-05
1801409123 Angel Bartlett Social Worker 2357 Brookmoor Ln, Woodbridge, VA 22191-4083 2020-08-26
1306308234 Emily Manza Social Worker 16012 Indus Dr, Woodbridge, VA 22191-4336 2019-04-01
1053885707 Shatiera Monique Amankrah Social Worker 3733 Hetten Ln, Woodbridge, VA 22193-1048 2019-01-16
1922576099 Paula Dorman Social Worker 4001 Prince William Pkwy Ste 300, Woodbridge, VA 22192-7667 2018-11-07
1417444910 Mallory Grimste LLC Social Worker 30 Hazel Ter Ste 12, Woodbridge, CT 06525-2240 2018-04-19
1003315391 Sage Community Counseling LLC Social Worker 2239b Tacketts Mill Dr, Woodbridge, VA 22192-3026 2018-02-02
1568902765 Tabitha Mann Social Worker 12191 Cardamom Dr, Woodbridge, VA 22192-1448 2017-03-07
1184169765 Mahogany Lacour Social Worker 4197 Windflower Ct, Woodbridge, VA 22193-5100 2017-01-05
1932655354 Kayla Marie Lucas Social Worker 1 Bradley Rd Ste 404405, Woodbridge, CT 06525-2285 2016-08-26
Find all providers in WOODBRIDGE

Competitor

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City WOODBRIDGE
Zip Code 22192

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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