Provider Demographics
NPI:1154181626
Name:ALFRED, AYASIA (LMSW)
Entity type:Individual
Prefix:
First Name:AYASIA
Middle Name:
Last Name:ALFRED
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6026 RICKETTS WALK
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-2769
Mailing Address - Country:US
Mailing Address - Phone:163-186-0838
Mailing Address - Fax:
Practice Address - Street 1:5620 SAINT BARNABAS RD STE 312
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3628
Practice Address - Country:US
Practice Address - Phone:443-963-3486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30938104100000X
DCLG50083110104100000X
VA0903002857104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker