Individual provider · NPI-1

Staci M Bostic, LCSW

Social Worker, Clinical · Ashburn, VA

NPI number1477645828
StatusActive
Last updated in NPPESSep 14, 2018

Details

NPI
1477645828
Entity type
Individual (NPI-1)
Name
Ms. Staci M Bostic
Credential
LCSW
Sex
Female
Sole proprietor
No
Enumeration date
Sep 29, 2006
Last updated
Sep 14, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical0904004116VAYes

Practice location

44075 Pipeline Plz Ste 220
Ashburn, VA 20147-5890

Phone 703-283-9083 · Fax 703-738-7258

Mailing address

44075 Pipeline Plz Ste 220
Ashburn, VA 20147-5890

Phone 703-283-9083

Other practice locations

21785 Filigree Ct
Ashburn, VA 20147-6213

Phone 703-724-0335

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