Provider Demographics
NPI:1558119313
Name:KEMP, AYSHA (MSW)
Entity type:Individual
Prefix:
First Name:AYSHA
Middle Name:
Last Name:KEMP
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 WALNUT ST STE 250
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-4750
Mailing Address - Country:US
Mailing Address - Phone:703-878-3290
Mailing Address - Fax:
Practice Address - Street 1:12751 MARBLESTONE DR STE 200
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-8337
Practice Address - Country:US
Practice Address - Phone:703-878-3290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical