Healthcare Provider Details

I. General information

NPI: 1891727251
Provider Name (Legal Business Name): MEREDITH LINDSEY JOHNSON GELMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 12/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 CHURCH ST NW STE 300A
VIENNA VA
22180-4437
US

IV. Provider business mailing address

8323 PRIVATE LN
ANNANDALE VA
22003-4473
US

V. Phone/Fax

Practice location:
  • Phone: 703-463-7916
  • Fax: 703-938-8393
Mailing address:
  • Phone: 703-426-4945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904003553
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: