Healthcare Provider Details

I. General information

NPI: 1659761724
Provider Name (Legal Business Name): CHRISTIAN PASIAN GEYE LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2015
Last Update Date: 05/05/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5272 LYNGATE CT., SUITE 201
BURKE VA
22015
US

IV. Provider business mailing address

5272 LYNGATE CT., SUITE 201
BURKE VA
22015
US

V. Phone/Fax

Practice location:
  • Phone: 571-317-8174
  • Fax:
Mailing address:
  • Phone: 571-317-8174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLG60666482
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0717001593
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMG60275941
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: