Individual provider · Type 1 NPI

Gina Park

Clinical Social Worker · Fairfax, VA

NPI number 1477934743 Active

Practice location

10195 Main St Ste O
Fairfax, VA 22031-3415

Mailing address

9068 Andromeda Dr
Burke, VA 22015-3510

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X0904008989 (VA)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1477934743

Gina Park's National Provider Identifier is 1477934743, issued on Jun 12, 2015. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Fairfax, VA. The record was last updated on May 29, 2025.