Provider Demographics
NPI:1609177765
Name:BOLAND, EMILY KIRBY (MSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:KIRBY
Last Name:BOLAND
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 1:114 W GREENWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4005
Mailing Address - Country:US
Mailing Address - Phone:703-300-3285
Mailing Address - Fax:
Practice Address - Street 1:1608 SPRING HILL RD
Practice Address - Street 2:SUITE 300
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2241
Practice Address - Country:US
Practice Address - Phone:703-831-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040074601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical