Provider Demographics
NPI:1487867586
Name:GOLDFARB, ANDREW (LCSW-C, LCSW, CSOTP)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:GOLDFARB
Suffix:
Gender:M
Credentials:LCSW-C, LCSW, CSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4517
Mailing Address - Country:US
Mailing Address - Phone:240-457-9010
Mailing Address - Fax:
Practice Address - Street 1:254 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4517
Practice Address - Country:US
Practice Address - Phone:240-457-9010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD108461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical