Provider Demographics
NPI:1194957704
Name:KHAN, SAJJAD A (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:SAJJAD
Middle Name:A
Last Name:KHAN
Suffix:
Gender:M
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 ELDEN ST
Mailing Address - Street 2:SUITE 17
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4872
Mailing Address - Country:US
Mailing Address - Phone:703-787-9090
Mailing Address - Fax:703-787-8845
Practice Address - Street 1:106 ELDEN ST
Practice Address - Street 2:SUITE 17
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4872
Practice Address - Country:US
Practice Address - Phone:703-787-9090
Practice Address - Fax:703-787-8845
Is Sole Proprietor?:No
Enumeration Date:2009-08-14
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040076221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical