Provider Demographics
NPI:1104318948
Name:GANJALIKHANI, SAHAR (LCSW)
Entity type:Individual
Prefix:
First Name:SAHAR
Middle Name:
Last Name:GANJALIKHANI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 WASHINGTON BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-5717
Mailing Address - Country:US
Mailing Address - Phone:703-228-1700
Mailing Address - Fax:703-228-1756
Practice Address - Street 1:2100 WASHINGTON BLVD FL 4
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-5717
Practice Address - Country:US
Practice Address - Phone:703-228-1700
Practice Address - Fax:703-228-1756
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040105031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical