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NPI Code Detail

MEDICARE: MRS. MARY ELIZABETH (BETS) BYRNE L.C.S.W.

MEDICARE:  MRS. MARY ELIZABETH (BETS) BYRNE  L.C.S.W.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker0904000620VA

General Provider Information

NPI Number : 1790903755
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY ELIZABETH (BETS) BYRNE L.C.S.W.
Provider Business Mailing Address
First Line : 5808 MALLOW TRL
Second Line :
City : LORTON
State : VA
Zip : 22079-4200
Country : US
Telephone Number : 703-339-6741
Fax Number :
Provider Business Practice Location Address
First Line : 12866 HARBOR DR
Second Line :
City : WOODBRIDGE
State : VA
Zip : 22192-2921
Country : US
Telephone Number : 703-490-3346
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. MARY ELIZABETH (BETS) BYRNE L.C.S.W.” Practice Location

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