=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235836180
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SVANDIS GEIRSDOTTIR LCSW LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/10/2023
-----------------------------------------------------
Last Update Date | 02/10/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 109 ORONOCO ST
-----------------------------------------------------
City | ALEXANDRIA
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22314-2015
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-283-9163
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 109 ORONOCO ST
-----------------------------------------------------
City | ALEXANDRIA
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22314-2015
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-283-9163
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/THERAPIST
-----------------------------------------------------
Name | MS. SVANDIS GEIRSDOTTIR
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 703-283-9163
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------