Healthcare Provider Details

I. General information

NPI: 1073042156
Provider Name (Legal Business Name): SVANDIS GEIRSDOTTIR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2355B MILL RD
ALEXANDRIA VA
22314-4608
US

IV. Provider business mailing address

2355B MILL RD
ALEXANDRIA VA
22314-4608
US

V. Phone/Fax

Practice location:
  • Phone: 703-746-3639
  • Fax: 703-746-3584
Mailing address:
  • Phone: 703-746-3639
  • Fax: 703-746-3584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904009398
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: