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General NPI Number Information
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NPI Number | 1770748774
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Entity Type | Individual
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Provider Name | CYNTHIA N YELLEN LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/20/2008
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | POST OFFICE BOX 145
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City | FAIRFAX STATION
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State | VA
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Zip | 22039-0145
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Country | US
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Telephone | 703-828-4267
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Fax | 271-255-6004
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Provider Business Mailing Address
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Address Line | POST OFFICE BOX 145
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City | FAIRFAX STATION
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State | VA
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Zip | 22039-0145
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Country | US
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Telephone | 703-828-4267
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Fax | 271-255-6004
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904003788
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License Number State | VA
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