Provider Demographics
NPI:1558499616
Name:EDDINS, GEORGIANNA (PHD, MS, LPC, LCP)
Entity Type:Individual
Prefix:DR
First Name:GEORGIANNA
Middle Name:
Last Name:EDDINS
Suffix:
Gender:F
Credentials:PHD, MS, LPC, LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 CEDAR MILL CT
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182
Mailing Address - Country:US
Mailing Address - Phone:703-207-0662
Mailing Address - Fax:703-207-0662
Practice Address - Street 1:6723 WHITTIER AVENUE
Practice Address - Street 2:SUITE 408
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101
Practice Address - Country:US
Practice Address - Phone:703-288-0884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004414103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6375OtherCARE FIRST BCBS
VAB5240080OtherCARE FIRST BCBS