Provider Demographics
NPI:1225052871
Name:BRYCELAND, EILEEN N (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:N
Last Name:BRYCELAND
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 1:8348 TRAFORD LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-1663
Mailing Address - Country:US
Mailing Address - Phone:703-866-2129
Mailing Address - Fax:703-451-7539
Practice Address - Street 1:8348 TRAFORD LN
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1663
Practice Address - Country:US
Practice Address - Phone:703-866-2129
Practice Address - Fax:703-451-7539
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040047711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical