Provider Demographics
NPI:1114182375
Name:BINDER, JEANNE COSTIN (LCSW)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:COSTIN
Last Name:BINDER
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 1:5944 OHARA LANDING CT
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-2510
Mailing Address - Country:US
Mailing Address - Phone:703-250-4810
Mailing Address - Fax:703-250-5413
Practice Address - Street 1:5944 OHARA LANDING CT
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-2510
Practice Address - Country:US
Practice Address - Phone:703-250-4810
Practice Address - Fax:703-250-5413
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-26
Last Update Date:2008-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040065641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical