Provider Demographics
NPI:1639211584
Name:MASKELL, GERI H (MSW)
Entity Type:Individual
Prefix:MRS
First Name:GERI
Middle Name:H
Last Name:MASKELL
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 1:5021 SEMINARY RD
Mailing Address - Street 2:SUITE 229
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1945
Mailing Address - Country:US
Mailing Address - Phone:703-550-4804
Mailing Address - Fax:703-931-1931
Practice Address - Street 1:5021 SEMINARY RD
Practice Address - Street 2:SUITE 229
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1945
Practice Address - Country:US
Practice Address - Phone:703-550-4804
Practice Address - Fax:703-931-1931
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040003921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA638213Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER