Provider Demographics
NPI:1487197877
Name:BOND, JEAN (LCSW)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:BOND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3251 OLD LEE HWY STE 402
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-1504
Mailing Address - Country:US
Mailing Address - Phone:703-859-4608
Mailing Address - Fax:
Practice Address - Street 1:3251 OLD LEE HWY STE 402
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-1504
Practice Address - Country:US
Practice Address - Phone:703-859-4608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-02
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099245441041C0700X
VA09040097111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical