Staci M Bostic, Lcsw | |
44075 Pipeline Plz Ste 220 Ashburn VA 20147-5890 | |
(703) 283-9083 | |
(703) 738-7258 |
Full Name | Staci M Bostic, Lcsw |
---|---|
Speciality | Social Worker - Clinical |
Location | 44075 Pipeline Plz Ste 220, Ashburn, Virginia |
Authorized Official Name and Position | Staci M Bostic (OWNER) |
Authorized Official Contact | 7032839083 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Staci M Bostic, Lcsw 43385 Sperrin Ct Ashburn VA 20147-4548 Ph: (703) 283-9083 | Staci M Bostic, Lcsw 44075 Pipeline Plz Ste 220 Ashburn VA 20147-5890 Ph: (703) 283-9083 |
NPI Number | 1922527514 |
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Provider Enumeration Date | 09/14/2017 |
Last Update Date | 09/13/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922527514 | NPI | - | NPPES |
1477645828 | Other | VA | BLUE CROSS BLUE SHIELD OF VIRGINIA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 0904004116 (Virginia) | Primary |
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