Provider Demographics
NPI:1629138177
Name:O'BEIRNE, EILEEN GARDNER (LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:GARDNER
Last Name:O'BEIRNE
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:9828 SQUAW VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-1959
Mailing Address - Country:US
Mailing Address - Phone:703-838-6400
Mailing Address - Fax:703-838-5070
Practice Address - Street 1:720 N SAINT ASAPH ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-1912
Practice Address - Country:US
Practice Address - Phone:703-838-4600
Practice Address - Fax:703-838-5070
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001725101YP2500X
VA0717000838106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA57810129OtherBLUE CROSS BLUE SHIELD
VA8500299080OtherAMERIGROUP VIRGINIA INC.
VA8200187424OtherANTHEM
VA546001103002OtherTRICARE