Healthcare Provider Details

I. General information

NPI: 1194726794
Provider Name (Legal Business Name): ERIC DANIEL CIPRIANO LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 04/28/2022
Certification Date: 04/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 ARLINGTON BLVD, FOREIGN SERVICE INSTITUTE FSI/TC/CEFAR
ARLINGTON VA
22204-2220
US

IV. Provider business mailing address

PO BOX 2463
YORKTOWN VA
23692-5463
US

V. Phone/Fax

Practice location:
  • Phone: 703-746-2937
  • Fax:
Mailing address:
  • Phone: 915-203-7487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1897
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29983
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number1401142966
License Number StateVA
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904010218
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: