=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982254058
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LYNANNE HELEN BOPP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/19/2019
-----------------------------------------------------
Last Update Date | 11/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 801 N QUINCY ST STE 601
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22203-1729
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-812-4642
-----------------------------------------------------
Fax | 443-279-0738
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2331 YORK RD STE 100
-----------------------------------------------------
City | TIMONIUM
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21093-2246
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-823-6408
-----------------------------------------------------
Fax | 443-279-0738
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------