Provider Demographics
NPI:1275692923
Name:GEREN, JULIANA (MSW)
Entity Type:Individual
Prefix:MS
First Name:JULIANA
Middle Name:
Last Name:GEREN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1358 KIRBY ROAD
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-2409
Mailing Address - Country:US
Mailing Address - Phone:703-734-9838
Mailing Address - Fax:703-356-0815
Practice Address - Street 1:1358 KIRBY ROAD
Practice Address - Street 2:
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-2409
Practice Address - Country:US
Practice Address - Phone:703-734-9838
Practice Address - Fax:703-356-0815
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040001151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GE425333Medicare ID - Type Unspecified