MEDICARE: MIRI EYNAN MSW, LCSW

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
1	1041C0700X	Clinical Social Worker	0904008552	VA

General Provider Information

NPI Number	:	1891183703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRI EYNAN MSW, LCSW

Provider Business Mailing Address
First Line	:	5241 COBBLERS STONE CT
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059-7542
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8100 THREE CHOPT RD
Second Line	:	SUITE 133
City	:	RICHMOND
State	:	VA
Zip	:	23229-4833
Country	:	US
Telephone Number	:	804-356-6992
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2014
Last Update Date	:	06/07/2026

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