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General NPI Number Information
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NPI Number | 1659556587
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Entity Type | Organization
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Legal Business Name | AUTUMNLEAF GROUP, INC.
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 8983 HERSAND DR 2ND FLOOR
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City | BURKE
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State | VA
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Zip | 22015-1689
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Country | US
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Telephone | 703-658-7103
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Fax |
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Provider Business Mailing Address
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Address Line | 8983 HERSAND DR 2ND FLOOR
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City | BURKE
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State | VA
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Zip | 22015-1689
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Country | US
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Telephone | 703-658-7103
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | JANINE N HARRIGAN
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Credential | LCSW
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Telephone | 703-658-7103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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