Provider Demographics
NPI:1639559875
Name:GIRARD, EMILY N (MA LPC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:N
Last Name:GIRARD
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15941 DONALD CURTIS DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-4256
Mailing Address - Country:US
Mailing Address - Phone:703-792-4900
Mailing Address - Fax:703-792-5699
Practice Address - Street 1:15941 DONALD CURTIS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-4256
Practice Address - Country:US
Practice Address - Phone:703-792-4900
Practice Address - Fax:703-792-5699
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006153101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004945247Medicaid