Provider Demographics
NPI:1013209386
Name:CARLON, GERALDINE (LCSW)
Entity Type:Individual
Prefix:
First Name:GERALDINE
Middle Name:
Last Name:CARLON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S. ARLINGTON RIDGE RD
Mailing Address - Street 2:UNIT 212
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-1923
Mailing Address - Country:US
Mailing Address - Phone:703-304-6614
Mailing Address - Fax:
Practice Address - Street 1:1101 S. ARLINGTON RIDGE RD
Practice Address - Street 2:UNIT 212
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-1923
Practice Address - Country:US
Practice Address - Phone:703-304-6614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040011031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical