Provider Demographics
NPI:1386794782
Name:CARNEVALE, PATTI J (LCSW)
Entity type:Individual
Prefix:MS
First Name:PATTI
Middle Name:J
Last Name:CARNEVALE
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 1:2 PIDGEON HILL DR
Mailing Address - Street 2:SUITE 450
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-6145
Mailing Address - Country:US
Mailing Address - Phone:703-433-1553
Mailing Address - Fax:
Practice Address - Street 1:2 PIDGEON HILL DR
Practice Address - Street 2:SUITE 450
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6145
Practice Address - Country:US
Practice Address - Phone:703-433-1553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040020541041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist