Individual
CHRISTINA MADSEN FISHBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
218 N LEE ST STE 201, ALEXANDRIA, VA 22314-2631
(831) 236-5801
(703) 842-8135
Mailing address
3388 WILTON CREST CT, ALEXANDRIA, VA 22310-2354
(831) 236-5801
(703) 842-8135
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0903002595
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0903002595
COMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS
VA
Enumeration date
08/03/2018
Last updated
06/09/2021
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